Field Reimbursement Manager – Western US

Purpose and Scope

You will be responsible for the management and execution of field reimbursement strategies and tactics to facilitate patient access to the MISHA Knee System. You will assist in mitigating reimbursement barriers for providers, and for optimizing market access. You will be the collaborative bridge between the field Sales Team and strategic decision makers working closely with clinicians, administrators, and our sales and marketing teams

This is a highly customer-facing role, with a strong focus on day-to-day account support, provider education and case progression. The FRM will engage directly with customers across multiple touchpoints, serving as a key resource for reimbursement-related education and execution with assigned accounts.

Responsibilities

• Serve as a primary field reimbursement contact for assigned accounts, supporting a high volume of customer interactions (e.g., provider offices, ASC, and hospital administrators)
• Conduct daily customer calls and training, including:
  • myMISHA Patient Access portal education and onboarding
  • Provider and facility-level financial/reimbursement education
  • Coding, billing and documentation guidance
• Support and participate in Value Analysis Committee (VAC) meetings with hospital and ASC stakeholders by reinforcing reimbursement and program fundamentals
• Assist provider offices in navigating the reimbursement lifecycle, including prior authorizations, appeals, and claim follow-up
• Provide real-time troubleshooting and support for reimbursement related questions and barriers
• Partner with sales team to support account onboarding, early case execution, and ongoing program adoption
• Proactively engage commercial insurance Medical Directors, and medical policy decision-makers, to positively impact coverage for MISHA
• Proactively engage Medicare Contractor Medical Directors (CMDs), and medical decision-makers at regional MACs, to positively impact coverage for MISHA
• Gather, track, and analyze account-level and regional data and trends to:
  • Support sales team strategies and account planning
  • Inform Customer facing program reviews
  • Highlight adoption, pipeline, and reimbursement performance
• Communicate case updates, trends, and key insights back to internal stakeholders (e.g., Sales, Marketing, Patient Access)
• Reinforce best practices and drive consistent use of the myMISHA Patient Access Program
• Collaborate cross-functionally to ensure alignment on messaging, tools, and customer experience
• Apply working knowledge or payor reimbursement methodologies and contract structures to support provider and facility-level financial discussions.
• Support customer conversations related to new and emerging technologies, including how investigational and/or non-covered designations may impact access, reimbursement, and case progression.
• Reinforce appropriate positioning of reimbursement expectations based on contract terms, historical experience, and current market dynamics

JOB REQUIREMENTS:

Education and Training

• A Bachelor of Arts or Science Degree, or equivalent combination of experience/education.
• 5+ years of medical device reimbursement, market access and/or health economics experience.
• Understands medical reimbursement (billing, coding, coverage, and payment) in the healthcare system & experience with unlisted codes (e.g., 27599), and new technology codes (e.g., “C” codes)
• Understands typical VAC processes.
• Demonstrates knowledge and experience with US private payors and Medicare coverage and payment.
• Experience proactively reaching out to payors to positively impact coverage preferred.
• High level of interpersonal skills: influencing, resolving conflict, and creative problem solving.
• Must be an excellent communicator and educator.
• Strong written, verbal and presentation skills with the ability to present and persuade physicians, physician offices, hospital administrators, and KOLs with respect to the Company’s reimbursement strategies.
• Previous experience working closely and collaboratively with field sales teams.
• Comfortable working virtually, with flexible workplace arrangements and business virtual technologies.
• The ability to manage complex problems and projects while exercising independent decision-making and analytical thinking skills, with minimal supervision.
• This position is field based. Ability to travel up to 50% of the time.
• Proximity to major airport preferred.