Mgr, Health Economics Reimbursement - Coverage and Payment

Innovation starts from the heart. Heart valve disease and critical care therapies impact millions of lives, spanning all ages and geographies. As communities globally address the opportunities and challenges of cardiovascular care, telling a compelling and authentic story is more crucial than ever. Beyond raising awareness, our Marketing teams build lasting, trusted relationships with medical professionals and industry stakeholders to ensure patients can receive the treatments they need.

Position Summary:

This is a great opportunity to join a Global Health Economics & Reimbursement (GHER) team that is playing a key role in the success of our Transcatheter Heart Valve (THV) business at Edwards Lifesciences.

As a Manager of Coverage and Payment policy, you will assist in supporting the management of reimbursement tools; maintain coverage and payment policy strategies to address market access needs that support our THV business unit. This position is based at the corporate headquarters in Irvine, California.

How you will make an impact:

Contribute to the development of market access (coding, coverage, payment) strategies and resources that enhance patient access to THV therapies.

Establish detailed understanding and ability to navigate payers? (e.g., central Medicare, Medicare contractors, and private insurers) coverage and payment processes, including ongoing monitoring of policy issues.

Support internal and external stakeholders (e.g., health economics team, payers) while leveraging knowledge gained through direct interactions and relationships, to provide relevant input to coverage and payment conversations.

Collaborate with internal Government Affairs, Healthcare Policy, and Reimbursement and Health Economics teams to assist with the management of advocacy relationships with regional KOLs and societies, trade party associations and other key third parties to influence outcomes of critical policy issues.

Monitor changes in the external environment (health policy, insurance and regulatory) and advise senior leadership on threats and opportunities with suggested action plans.

Support the development and management of tools that provide education to internal and external stakeholders on relevant market access, policy and reimbursement related issues.

Other health economics and reimbursement special projects, as assigned.

What you will need (required):

The successful candidate will develop synergies across the organization and foster strong internal and external relationships to achieve market access goals and objectives. Critical skills and experience for this position include:

Bachelor's degree in a life science, health economics, healthcare finance, health policy, or related field.

A minimum of 8 years related experience in med tech, health plan, government payer, or healthcare policy is required or 6 years with a master's degree.

What else we look for (preferred):

Master's degree in a life science, health economics, healthcare finance, health policy, public policy, or related field preferred.

Previous experience in, or strong working knowledge of medical device industry, private or public payer, reimbursement knowledge or experience is preferred and a strong plus.

Experience working with external stakeholders and customers (e.g., vendors, payers, hospitals, physicians, etc.), as well as internal cross-functional teams and business units.

Excellent interpersonal and communication skills, especially presentation development.

Exceptional project management skills.

Strong business acumen, analytical skills and experience working with various internal business partners (especially Sales, Marketing, Medical Affairs, Clinical, Regulatory, Legal, and Government Affairs staff) to provide insight into key market access issues.

Self-motivated and able to advance projects with limited supervision, yet capable of taking direction and being a willing collaborator with other team members.

Domestic travel up to 10%

Aligning our overall business objectives with performance, we offer competitive salaries, performance-based incentives, and a wide variety of benefits programs to address the diverse individual needs of our employees and their families.

For California, the base pay range for this position is $120,000 to $170,000 (highly experienced).

The pay for the successful candidate will depend on various factors (e.g., qualifications, education, prior experience).

Applications will be accepted while this position is posted on our Careers website.

Edwards is an Equal Opportunity/Affirmative Action employer including protected Veterans and individuals with disabilities.

COVID Vaccination Requirement

Edwards is committed to protecting our vulnerable patients and the healthcare providers who are treating them. As such, all patient-facing and in-hospital positions require COVID-19 vaccination. If hired into a covered role, as a condition of employment, you will be required to submit proof that you have been vaccinated for COVID-19, unless you request and are granted a medical or religious accommodation for exemption from the vaccination requirement. This vaccination requirement does not apply in locations where it is prohibited by law to impose vaccination.