Description
Overview: The Principal Payor Relations and Reimbursement Liaison is responsible for supporting Sight Sciences' products and portfolio to assigned geographic areas including hospitals, ASCs, surgeons, and payers. Successful performance will include ensuring the execution of Market Access Reimbursement strategy that provides fair and consistent payment and removing barriers in the overall reimbursement process. This position will also be responsible for supporting field sales leadership by coordinating a strategy that supports a variety of customers, including payers, physicians, nurses, billing staff, hospital outpatient departments, and ASCs. This role will be accountable to serving as an expert in payer reimbursement policies and providing support to facilitate appropriate patient & provider access and utilization of services to ensure their access to care. Under the direction and leadership of the Principal Payor Relations and Reimbursement Liaison, the Principal Payor Relations and Reimbursement Liaison will work in close collaboration with Marketing, Commercial Marketing, Medical Affairs, R&D, and Clinical teams to ensure market access and competitive advantage of Sight Sciences products by developing and executing strategies that integrate health economics, outcomes research and market access solutions across all stages of the product lifecycle. Responsibilities:
- Engage with key payers within geographic regions to ensure coverage and reimbursement of company technologies
- Develop relationships to support future pipeline needs
- Work closely with Sales, lead customer-facing reimbursement and market access needs for assigned geography
- Deliver presentations to payers to establish and/or improve reimbursement coverage policies, coding, and payment assignments utilizing available resources
- Promote reimbursement support and represent the company to external customers by writing, phoning, visiting, hosting, and participating in events
- Serve as a content expert when representing the company with internal and external customers
- Build programs to engage economic stakeholders, including payers and providers, expanding access to care
- Evaluate incoming requests from the field and ensure each request is properly evaluated for feasibility, technical risk, cost and time constraints, compliance, and other relevant considerations
- Partner with internal and external stakeholders to ensure patient-reported outcomes, economic endpoints, and other evidence are included in, or separate from, trials to support economic modeling, economic value assessments, patient preference, and patient-focused value proposition
- Work closely with Regional & National Sales Leadership to inform commercial strategy and appropriately support healthcare providers with their reimbursement needs
- Networking with regional and state providers, patients, and healthcare systems advocacy organizations
- Develop sustainable corporate relationships that will allow for current and future product growth
Skills/Qualifications:
Bachelor's degree in a HEMA-related discipline in health economics, outcomes research, or healthcare-related field or equivalent experience required
The ideal candidate will have a minimum of 10 years of experience in a highly regulated field and a minimum of 4 years of commercial medical device, pharma, or consulting business is preferred
Strong business acumen, analytical skills, and experience working with various internal business partners (especially Sales, Marketing, Clinical, Regulatory, Legal, and Government Affairs staff)
Understanding of key public and private payer policy infrastructure, payment methodologies, coding, and coverage; health policy trends and current business challenges
Previous experience in, or strong working knowledge of the medical device industry, especially with functional responsibility in health economics and reimbursement planning and program implementation
Experience working with external stakeholders such as payers, hospitals, physicians, trade associations, and professional and medical organizations to develop mutually beneficial health economics and reimbursement strategies and tactics to support portfolio planning, commercialization, and sales/marketing objectives
Possess the ability to work independently from strategy development (direct or indirect) to execution with multiple stakeholder types
Solid knowledge of evidence needed to drive favorable US reimbursement and market access is required
Successful candidates will have a track record of success in evidence-based medicine, market development, health economics, reimbursement, or health policy
Strong understanding of the US reimbursement systems and market access trends
Ability to communicate clearly and concisely to large audiences; detail-oriented, self-motivated, and able to work independently
Ability to take evidence and other complex data and package it into easy-to-understand deliverables that can support commercial use
Intellectual interest in keeping abreast of market access and reimbursement trends
Solution-oriented, with the ability to offer creative options for problem-solving
Work closely with multiple cross-functional partners, including Sales, Strategic Marketing, Business Development, Medical Affairs, Clinical Research, US Commercial Marketing, Regulatory Affairs, R&D, and Legal
- Sitting for extended periods, the employee regularly works in an office environment and meetings at physician offices or hospitals and payers as required
The percentage of expected travel for domestic, international, or both is estimated to be 20%
#LI-Remote
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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