Field Reimbursement Manager

Johnson & Johnson Innovative Medicine•Santa Clara, MO

1d•$102,000 - $203,550

About The Position

The Field Reimbursement Manager is responsible for contributing to the development and execution of strategic reimbursement initiatives that lead to improved patient and market access of Shockwave Medical products. Successful candidates will have excellent technical expertise in the areas of healthcare administration and delivery, facility and physician reimbursement, sales education, and health economic value messaging. This highly visible role will work with internal and external customers at the field level on strategic coding, coverage, and reimbursement issues. This position plays a key role in supporting patient access to our therapies and devices by providing expert reimbursement and access support to Hospitals, ASCs, and physician practices. This role ensures that customers understand coverage, coding, and payment pathways; resolving access barriers; and helping facilities integrate appropriate reimbursement processes to support sustainable adoption across Shockwave’s portfolio of products.

Requirements

Bachelor’s degree in business, economics, or health-related subject or equivalent experience
Experience in healthcare, insurance and/or reimbursement field with particular emphasis on coding, coverage, and payment issues. Medical device experience preferred
6-8 years reimbursement policy and/or payer experience within a medical device company, healthcare provider, or healthcare consulting firm
At least 3 years field reimbursement experience in Hospital setting
Working knowledge of healthcare economics, managed care and government payer business practices, health policy development, and advocacy
Demonstrated ability to interpret and translate billing, coding, coverage, and payment information and communicate these concepts to all levels of the organization
Ability to review aspects of medical documentation and verify medical criteria as cases are reviewed
Individual must be able to work in a fast-paced and demanding environment, capable of managing high pressure situations with both internal and external customers
Ability to work independently and problem-solve with minimum supervision in a field-based role with significant visibility to sales leadership is critical
Strong analytic and investigative skills; able to get to the bottom of an issue
Ability to translate complex reimbursement information into easy to implement strategies and tactics through exceptional written and verbal communication
Strong organization, prioritization skills needed; incumbent must be detail and deadline oriented
Ability to be perceived credibly and demonstrate excellent persuasion skills to achieve desired results
Travel up to 50% may be required

Nice To Haves

Account Management
Coaching
Competitive Landscape Analysis
Compliance Management
Consulting
Cross-Functional Collaboration
Escalation Management
Fact-Based Decision Making
Finance and Accounting Platforms
Financial Reports
Market Access Reimbursement
Market Opportunity Assessment
Performance Measurement
Pricing Strategies
Process Improvements
Strategic Thinking
Technical Credibility

Responsibilities

Reimbursement Tools & Materials Provide input and assist in the development of reimbursement materials and tools for customers (Physicians, Billing Staff, Coding Staff, Administrators, Revenue Cycle etc.) and the field sales team
Identify the educational needs of priority accounts and work with approved Shockwave tools to provide relevant training and education on coding, billing, and reimbursement
Develop monthly report of provider activities including regional trends and developments in support of quarterly updates to Senior Leadership
Reimbursement and Access Support Develop monthly report of provider activities including regional trends and developments in support of quarterly updates to Senior Leadership
Develop and implement reimbursement strategies and tactics aligned with Sales leadership that minimize or remove coding, coverage and payment barriers for Shockwave products and therapies
Serve as the primary field-based expert for reimbursement, coding, and coverage related to the company’s portfolio in the Hospital Inpatient, Outpatient, and ASC settings
Educate Hospital administrators, billing managers, and healthcare providers by delivering targeted training using approved tools on coding, billing, and reimbursement (e.g., DRGs/ICD‑10‑CM/PCS for IP; APCs/CPT/HCPCS for HOPD), documentation requirements, and claim workflows
Incorporate health economic value messaging into field reimbursement discussions by leveraging regional market data, hospital‑specific cost structures (IP DRG/APC reimbursement dynamics), and local payer coverage trends to help facilities understand the clinical, operational, and economic impact of the technology
Develop and communicate insights using localized utilization patterns, competitive landscape signals, and real‑world evidence to support hospital decision‑makers (finance, value analysis committee, revenue cycle, clinical leadership) in evaluating the therapy’s value proposition
Support customers in navigating Medicare, Medicaid, and commercial payer coverage policies and prior-authorization requirements
Provide one-on-one and group training on prior authorization, claim submission, appeals, and payment processes
Identify, triage, and resolve access barriers in collaboration with internal reimbursement support teams
Identify key issues and trends with commercial and government payers, determining and implementing appropriate solutions
Conduct webinars for new and existing customers (frequency to be determined and based on customer need). Track and report on customer attendance
Conduct webinars for new and existing customers (frequency to be determined and based on customer need). Track and report on customer attendance
Field Education and Relationship Management Partner with sales, marketing, and clinical teams to ensure seamless customer experience and compliance
Build and maintain strong relationships with Hospital administrators, clinical teams, billing & coding leads, and payer representatives and ensure tracking through CRM systems
Engage physicians to support payer advocacy by helping them interpret coverage requirements, communicate medical necessity, and partner in resolving access barriers.
Deliver in-person and virtual reimbursement workshops and policy update sessions
Monitor and communicate payer landscape changes relevant to the Hospital and ASC site of service
Monitor and communicate payer landscape changes relevant to the Hospital and ASC site of service
Cross-Functional Collaboration Collaborate with Market Access, Health Economics, Medical Affairs, and Compliance teams
Serve as the field liaison to the Shockwave Market Access team by delivering customer insights, trends and challenges gathered from the field
Provide field insights on reimbursement trends and Hospital operational models
Collaborate with Marketing colleagues on strategies that address the needs of key Government, Healthcare Agencies and Commercial Stakeholders, and that influence the economic and policy decisions on product coding and reimbursement.
Participate in initiatives supporting new product launches, coding applications, and payment advocacy efforts
Other duties as required
Ensure compliance with corporate and other regulatory requirements

Benefits

The anticipated base pay range for this position is : $118,000.00 - $203,550.00
The anticipated base pay range for this position is $102,000-177,100
Under current guidelines, this position is eligible for an annual performance bonus in accordance with the terms of the applicable plan.
Subject to the terms of their respective plans, employees are eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).
This position is eligible to participate in the Company’s long-term incentive program.
Vacation –120 hours per calendar year
Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado –48 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year
Holiday pay, including Floating Holidays –13 days per calendar year
Work, Personal and Family Time - up to 40 hours per calendar year
Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child
Bereavement Leave – 240 hours for an immediate family member: 40 hours for an extended family member per calendar year
Caregiver Leave – 80 hours in a 52-week rolling period10 days
Volunteer Leave – 32 hours per calendar year
Military Spouse Time-Off – 80 hours per calendar year