Senior Director, Reimbursement & Health Economics

Benefits include: Medical, Dental, and Vision Insurance, 401(k), Stock Options

NOTE: You must have a minimum of 10 years of progressive experience in reimbursement, market access, health economics, or related functions within the medical device industry to be considered for this position.

Providence Medical Technology, Inc. is a privately-held medical device company focused on innovation solutions for cervical spine conditions. The company has pioneered a proprietary approach to posterior cervical fusion and has developed surgical instrumentation and implants that offer unique benefits to the $2 billion worldwide cervical spine market.

Our purpose is to improve clinical outcomes for high-risk patients and prevent surgical failures of the cervical spine.

LOCATION

This is a remote position.

SUMMARY

The Senior Director, Reimbursement & Health Economics is responsible for developing and executing Providence Medical's reimbursement, coding, coverage, payment, and health economics strategies to support successful commercialization of the Company's spinal implant technologies. This individual serves as the Company's subject matter expert on market access and reimbursement, partnering across Sales, Marketing, Clinical Affairs, Regulatory Affairs, Product Development, and Executive Leadership to ensure reimbursement considerations are incorporated throughout the product lifecycle.

This is a senior individual contributor role requiring a strategic and hands-on leader who can independently develop reimbursement strategies while personally driving execution. The Senior Director will lead key initiatives related to coding, coverage, payment, and health economic evidence generation, while managing external consultants and cultivating relationships with physician leaders, specialty societies, government agencies, and commercial payers to advance patient access and technology adoption

MAIN RESPONSIBILITIES:

Strategic Reimbursement Leadership

• Develop and execute comprehensive reimbursement and market access strategies supporting the Company's current and future spinal implant portfolio.
• Serve as the internal expert on coding, coverage, payment, and health economics, providing strategic guidance to executive leadership and cross-functional teams.
• Integrate reimbursement strategy into product development, clinical evidence generation, regulatory planning, and commercialization activities.
• Monitor changes in reimbursement policies, healthcare regulations, and payment systems to identify opportunities and mitigate business risk.

Coding Strategy

• Lead development and execution of coding strategies supporting new and existing technologies.
• Collaborate with physician leaders and specialty societies to advance CPT coding initiatives through the American Medical Association (AMA) CPT Editorial Panel process.
• Develop and maintain strategies related to CPT, HCPCS, ICD-10-PCS, and other applicable coding systems.
• Work closely with internal and external stakeholders to ensure appropriate coding pathways support adoption of the Company's technologies.

Coverage & Payment Strategy

• Develop and execute Medicare and commercial payer coverage strategies to improve patient access.
• Lead engagement with CMS, Medicare Administrative Contractors (MACs), commercial payers, and other reimbursement stakeholders.
• Develop strategies supporting favorable physician, hospital, ambulatory surgery center, and outpatient payment.
• Identify reimbursement barriers and implement solutions that facilitate customer adoption and long-term commercial success.

Health Economics & Evidence Development

• Develop health economic and outcomes research (HEOR) strategies demonstrating the clinical and economic value of the Company's technologies.
• Partner with Clinical Affairs to identify evidence needs supporting reimbursement, coverage, and market adoption.
• Guide development of economic models, budget impact analyses, value dossiers, reimbursement tools, and supporting evidence.

Commercial & Cross-Functional Support

• Partner closely with Commercial Leadership, Marketing, Clinical Affairs, Regulatory Affairs, and Product Management, to support product launches and commercialization initiatives.
• Develop reimbursement education materials and provide training for the commercial organization.
• Support strategic customer meetings by serving as the Company's reimbursement expert.
• Manage external reimbursement consultants and advisors to ensure successful execution of strategic initiatives.

External Relationships

• Build and maintain productive relationships with physician key opinion leaders, specialty societies, payer organizations, professional associations, and reimbursement policy experts.
• Represent Providence Medical in interactions with the AMA, CMS, specialty societies, reimbursement organizations, and other external stakeholders.
• Participate in industry meetings and professional organizations to maintain awareness of reimbursement trends affecting the spinal implant market.

QUALIFICATIONS:

• Bachelor's degree in Business, Healthcare Administration, Health Economics, Public Health, Life Sciences, or related discipline.
• Minimum of 10 years of progressive experience in reimbursement, market access, health economics, or related functions within the medical device industry.
• Demonstrated experience supporting commercialization of spinal implant technologies.
• Proven success developing and executing coding, coverage, and payment strategies for innovative medical devices.
• Experience working with the AMA CPT Editorial Panel process, physician specialty societies, and reimbursement policy organizations.
• Strong understanding of Medicare, commercial payer reimbursement, physician payment systems, hospital reimbursement methodologies, and ambulatory payment systems.
• Experience managing external consultants and leading complex cross-functional initiatives.
• Excellent communication, presentation, negotiation, and relationship management skills.
• Demonstrated ability to independently develop strategy while personally executing key initiatives in a highly collaborative environment.

Competencies

• Strategic Thinking - Proficient; Utilizes knowledge of industry and market trends to develop long- term strategies based on the companys vision and mission; Ability to create business plans, modify and course correct based on changing conditions; Understands organizations strengths & weaknesses; Analyzes market and competition; Identifies external threats and opportunities to the achievement of the company goals and objectives.

• Subject Matter Expert - Is considered to have expert knowledge in a particular job/subject and the go-to for employees and managers within and across functions; willingly shares knowledge, insight and direction. May mentor/train others, consult, advise, lead projects, and be called upon to present information, data, project status, etc. Successful at balancing priorities. Subject Matter experts (SMEs) can have a huge impact on the growth and vision of the company; may contribute perspective to strategic initiatives and projects. Responsibilities vary based on role.

• Building Relationships - Exemplifies togetherness and actively works to bring cohesive and cooperative efforts to all he or she does; appreciates and supports selflessness; collaborates openly and proactively; communicates effectively, listens intently and responds appropriately; Approachable and builds solid relationships; Trustworthy - true to his or her word.

• Accountable - Takes the highest level of ownership; emphasizes reliability and personal obligation. Isnt afraid to own his or her mistakes and learn from them; accepts responsibility and works to do his or her part to the best of his or her abilities to achieve the desired outcome.

• Oral and Written Communication - Knows when it is better to communicate directly rather than through written format; Provides information when needed; Speaks clearly and persuasively in positive or negative situations; knows audience and adjusts appropriately when needed; Listens and asks clarifying questions; Responds well and participates appropriately in meetings. Knows when it is appropriate to provide written communication; Writes clearly and informatively, effectively delivering desired message; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

• Results Focused - Driven to meet or exceed specific goals and objectives quickly but without compromising ethics and/or acceptable standards. Keenly focused on results by successfully leveraging available resources. A problem solver who uses creatively to get the job done. Pushes others to exceed the bare minimum. Approaches work with a sense of urgency.

• Analytical - Synthesizes complex or diverse information and can relay the information in a manner others can understand; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures; Doesnt overthink things.