Many structural heart patients suffer from heart failure with limited options. Our Implantable Heart Failure Management (IHFM) team is at the forefront of addressing these unmet patient needs through pioneering technology that enables early, targeted therapeutic intervention. Our innovative solutions are not just transforming patient care but also creating a unique and exciting environment for our team members. It’s our driving force to help patients live longer and healthier lives. Join us and be part of our inspiring journey.

How you’ll make an impact:

Support the commercial team by addressing technology and procedure coding, coverage, and payment concerns, onboarding new accounts, and implementation process improvement for existing accounts.

Collaborate with payers policy coverage for procedure and technology to seek broader access and adequate reimbursement.

Conduct virtual and onsite meetings with customers to educate on appropriate use of product and procedure codes, documentation requirements, and billing best practices proactively.

Develop and implement strategies for healthcare providers and patient reimbursement.

Manage and maintain relationships with healthcare providers and payers, as necessary.

Ensure compliance with reimbursement regulations and guidelines

Monitor and report on reimbursement and payer landscape specific to heart failure Business Unit (BU) portfolio

Participate in the strategic direction of the Global Health Economics (GHER) organization specific to their assigned BU.

Provide training and education to internal teams, healthcare providers/patients on reimbursement activities and processes

Analyze and interpret healthcare reimbursement data and trends

Communicate with internal and external stakeholders to resolve reimbursement issues and ensure timely resolution.

Develop in-depth materials to demonstrate product value including economic models, value dossiers, and slide presentations in partnership with sales and GHER team members

Develop economic tools in support of new product launch readiness

 Identify areas of evidence development to support product claims (e.g., reduce cost, lower length of stay)

Monitor and report on reimbursement and payer landscape specific to EW portfolio

Participate in the strategic direction of the GHER organization specific to their assigned BU

Data mine from various sources to identify areas of opportunity for EW products and procedures (e.g., cost savings, quality of life)

Develop economic tools to include cost effectiveness analyses, budget impact models, and cost benefit

Identify and develop internal processes to optimize GHER efficiencies

What you’ll need (Required):

Bachelor's degree in healthcare administration, life science, health economics, health policy, or related field

8+ years of related experience in medical device, health economics and /or outcomes research and reimbursement

What else we look for (Preferred):

Experience in the medical device industry including, but not limited to coverage, coding, payment, insurance verification, prior authorizations, and/or claim adjudication, in facility and physician’s office or clinics.

Experience with government reimbursement programs, such as Medicare and Medicaid

Excellent project management skills

Strong leadership and management skills, with a focus on customer service

Strong knowledge of healthcare reimbursement regulations and guidelines

Excellent communication and interpersonal skills

Ability to analyze and interpret data

Excellent problem-solving skills and ability to make informed decisions

Ability to work independently and as part of a team

Proven ability to effectively handle multiple priorities and excellent organizational skills

Strong computer literacy to include PowerPoint and Web Meeting experience

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 Illinois, the base pay range for this position is $123,000 to $174,000 (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.