Director US Market Access Reimbursement & Health Economics
hace 20 horas
Knoxville
ViTAA Medical Solutions Inc. (“ViTAA”) is a growing medical-device software company developing AI-powered medical-image analysis technology for the assessment and ViTAA Medical Solutions Inc. (“ViTAA”) is a growing medical-device software company developing AI-powered medical-image analysis technology for the assessment and treatment of vascular aneurysms. ViTAA’s platform applies proprietary algorithms to medical images to characterize the aortic wall and support more personalized aneurysm-risk assessment, surveillance, and procedural planning. ViTAA is seeking an experienced Director of U.S. Market Access, Reimbursement & Health Economics to build and lead our U.S. market-access function. Reporting to the Chief Commercial Officer, this person will shape the strategy for coding, coverage, payment, payer engagement, institutional access, health economics, and customer reimbursement for the AiORTA Suite. This is a foundational leadership role for someone who can move comfortably between strategy and execution. The Director will engage directly with payers and healthcare organizations, translate clinical evidence into a compelling economic value story, guide customers through reimbursement and implementation considerations, and establish the operating model for a scalable market-access organization. What you will leadMarket access and payer engagement • Develop and execute the U.S. market-access and reimbursement strategy for AiORTA Plan and future AiORTA products, aligned with regulatory and commercial status., • Lead engagement with commercial insurers, Medicare stakeholders, health plans, governmental payers, large health systems, integrated delivery networks, group purchasing organizations, health maintenance organizations, the Department of Veterans Affairs, and Veterans Affairs Medical Centers., • Build relationships with payer medical directors, coverage-policy teams, health-plan executives, hospital leaders, finance and population-health leaders, revenue-cycle executives, and procurement organizations., • Create account-specific access strategies that connect clinical need, patient outcomes, workflow, resource utilization, economic value, reimbursement, and contracting considerations., • Identify the clinical and economic evidence required to support favorable coverage, payment, procurement, and technology-adoption decisions. Coding coverage and payment • Assess and advance appropriate CPT, HCPCS, ICD-10, hospital outpatient, physician and emerging-technology coding pathways., • Monitor and interpret CMS, Medicare Administrative Contractor, and commercial-payer policies affecting AI-enabled cardiovascular imaging and analytics., • Evaluate fee-for-service, hospital-funded, enterprise, per-study, pilot, and value-based access models., • Maintain accurate and compliant reimbursement guidance and convert changes in policy, claims experience, payment, and denials into actionable recommendations. Customer reimbursement and implementation • Serve as ViTAA's primary reimbursement resource for hospital, health-system, imaging, physician, and core-laboratory customers throughout evaluation, contracting, implementation, and ongoing use., • Educate customer revenue-cycle, finance, coding, billing, clinical, and administrative teams on coding, documentation, charge capture, claims submission, prior authorization, payment, denials, and appeals., • Develop reimbursement toolkits, billing guides, documentation guidance, payer resources, and customer education programs., • Train ViTAA's Commercial, Sales, National Accounts, Clinical, Marketing, Implementation, and Customer Success teams on reimbursement, health economics, and compliant communications. Health economics and evidence • Build a repeatable, defensible clinical and economic value story tailored to payers, health systems, the VA and other decision-makers., • Develop or coordinate value dossiers, payer briefing materials, budget-impact models, cost-consequence analyses, institutional business cases and customer-specific economic presentations., • Translate payer and institutional evidence requirements into recommendations for clinical studies, registries, economic analyses, real-world evidence and publication plans., • Support ViTAA's Economic Advisory Board and relationships with relevant professional societies, including reimbursement, coding, evidence and policy initiatives. Cross-functional leadership and function building • Lead cross-functional preparation and participation for payer, health-system, national-account, GPO, HMO and VA meetings, coordinating Commercial, Clinical, Medical, Scientific, Regulatory, Technology, Finance, Legal and Contracts perspectives., • Manage market-access, reimbursement, coding and health-economic advisors and vendors through clear scopes, deliverables, budgets, performance measures and decision rights., • Provide reimbursement, pricing, health-economic and implementation input into hospital, SaaS, strategic-partner, distributor and enterprise agreements., • Establish the strategy, processes, systems, dashboards, budgets and organizational roadmap for a scalable U.S. Market Access, Reimbursement and Health Economics function., • Recommend future staffing needs and assume direct management of approved hires as the function grows. What You Bring • Bachelor's degree, or equivalent international degree, in healthcare administration, business, health policy, health economics, public health, finance or a closely related field., • Ten or more years of progressive experience in U.S. healthcare reimbursement, market access, revenue cycle, payer relations, managed care or a closely related field., • Experience with AI-enabled cardiovascular imaging, digital diagnostics, software as a medical device or advanced imaging analytics., • Significant experience supporting medical technology, diagnostics, digital health, imaging, healthcare SaaS or another innovative healthcare technology., • Deep knowledge of U.S. coding, coverage and payment, including Medicare and commercial-payer processes, hospital and physician billing, medical-necessity policies, prior authorization, claims, denials and appeals., • Demonstrated success developing and presenting clinical and economic value propositions to payers, health systems and senior healthcare decision-makers., • Experience engaging payer medical directors, health-plan executives, hospital administrators, revenue-cycle leaders, procurement organizations or comparable institutional stakeholders., • Experience leading cross-functional customer-facing initiatives and managing external reimbursement, coding, health-economic or market-access advisors., • Strong executive presence and exceptional written, presentation, analytical, project-management, negotiation and leadership skills., • The judgment and initiative to operate independently in a growth-stage company while remaining highly collaborative and accountable., • Ability and willingness to travel approximately 25%-40%, including overnight travel. Preferred Qualifications • Advanced degree such as an MBA, MHA, MPH or master's degree in health economics, health policy or a related discipline., • Experience advancing an emerging reimbursement pathway toward established coding, sustainable coverage and payment., • Prior leadership of field reimbursement personnel or a market-access function., • Experience working with large health systems, IDNs, GPOs, HMOs, the VA, professional medical societies, advisory boards, CMS or commercial payers., • Experience developing value dossiers, budget-impact analyses, hospital business cases or real-world economic evidence., • Relevant professional certification in healthcare finance, revenue cycle, coding or project management, such as HFMA CHFP or CRCR, AAPC CPC or COC, or PMP. Why Join ViTAA This role offers the opportunity to build a critical commercial capability from the ground up and influence how an emerging precision-cardiovascular technology reaches the U.S. market. The Director will have direct access to executive leadership, meaningful input into evidence and commercialization strategy, and the mandate to create a function capable of supporting long-term growth. Equal Employment Opportunity ViTAA Medical Solutions is an equal opportunity employer and considers qualified applicants without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity or expression, national origin, ancestry, age, disability, genetic information, veteran status, marital status, or any other status protected by applicable law. Reasonable accommodations will be provided to qualified individuals with disabilities as required by law.
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