Director, Reimbursement & Market Access
PolyNovo Limited, California, Missouri, United States, 65018
Overview
At PolyNovo, we are committed to improving the outcomes of patients through the development and provision of the best surgical solutions possible. PolyNovo develops innovative medical devices utilizing the patented bioabsorbable polymer technology NovoSorb®. Our lifesaving and life-changing products have revolutionized the treatment of burns and major trauma, and have multiple emerging indications. With 130 employees in the U.S. and over 300 worldwide, PolyNovo has positively impacted the lives of more than 65,000 patients globally.
About The Role The Director of Reimbursement & Market Access will lead the strategic development and execution of reimbursement and health economics (HEOR) strategies for PolyNovo’s portfolio. You will be responsible for ensuring that patients have timely access to NovoSorb technology by securing favorable coverage policies and navigating the complexities of hospital value analysis committees (VACs), Medicare/Medicaid, and private payers.
Responsibilities
Develop and execute comprehensive market access launch plans for new products and line extensions.
Monitor and influence coding, coverage, and payment policies (DRGs, CPT codes, HCPCS) relevant to dermal substitutes and synthetic skin grafts.
Lead the development of the "Value Dossier" to articulate PolyNovo’s economic and clinical advantages over traditional biological scaffolds.
Engage directly with key medical directors at national and regional payers to secure positive medical policy coverage.
Support the field sales team by providing tools and messaging to navigate Hospital Value Analysis Committees (VACs).
Address reimbursement barriers by providing education to billing and coding departments.
Collaborate with the Clinical Affairs team to identify gaps in data and develop "Real World Evidence" (RWE) that demonstrates long-term cost savings (e.g., reduced length of stay, fewer surgeries).
Manage the creation of budget impact models and cost-effectiveness analyses.
Represent PolyNovo in industry trade associations (e.g., AdvaMed).
Stay abreast of legislative changes such as the Inflation Reduction Act or updates to the Physician Fee Schedule that impact medical device reimbursement.
Qualifications
Bachelor’s degree in Life Sciences, Economics, or Business. MPH, MBA, or PharmD preferred.
8+ years in Medical Device Market Access or Reimbursement. Experience in Wound Care, Trauma, or Aesthetics is a significant plus.
Deep understanding of US coding (CPT, ICD-10, HCPCS) and the OPPS/IPPS payment systems.
Ability to travel up to 30-40% for payer meetings and site visits.
The “PolyNovo Fit”: As a growth-stage company, we value a "player-coach" mentality—someone who can set the high-level strategy but isn’t afraid to dive into a specific claim denial or spreadsheet.
Relationship Driven: Existing relationships with CMS or major private payers (UnitedHealth, Aetna, etc.) are highly valued.
Complex Problem Solver: Ability to communicate the value of synthetic materials in a market historically dominated by biologic.
Benefits
Total compensation package consisting of base salary, bonus, and incentive plans
401k plan with company match
Comprehensive medical, dental, and vision insurance for employees and their families
Generous paid time off, 12 company holidays, and two paid Nurture days per year
Parental leave for primary and secondary caregivers
The salary range for this position is $181,600 - $216,000.
We like AI for lots of things, but we do not use it for résumé review. Your application is read by actual human beings. No automated screening tools are used in our hiring decisions.
PolyNovo fosters an environment that promotes equity, diversity, and inclusion. We recognize and value that it is the sum of our parts – our combined backgrounds, experiences and perspectives – that allow us to succeed. PolyNovo is an equal opportunity employer and provides equal employment opportunities to all applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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About The Role The Director of Reimbursement & Market Access will lead the strategic development and execution of reimbursement and health economics (HEOR) strategies for PolyNovo’s portfolio. You will be responsible for ensuring that patients have timely access to NovoSorb technology by securing favorable coverage policies and navigating the complexities of hospital value analysis committees (VACs), Medicare/Medicaid, and private payers.
Responsibilities
Develop and execute comprehensive market access launch plans for new products and line extensions.
Monitor and influence coding, coverage, and payment policies (DRGs, CPT codes, HCPCS) relevant to dermal substitutes and synthetic skin grafts.
Lead the development of the "Value Dossier" to articulate PolyNovo’s economic and clinical advantages over traditional biological scaffolds.
Engage directly with key medical directors at national and regional payers to secure positive medical policy coverage.
Support the field sales team by providing tools and messaging to navigate Hospital Value Analysis Committees (VACs).
Address reimbursement barriers by providing education to billing and coding departments.
Collaborate with the Clinical Affairs team to identify gaps in data and develop "Real World Evidence" (RWE) that demonstrates long-term cost savings (e.g., reduced length of stay, fewer surgeries).
Manage the creation of budget impact models and cost-effectiveness analyses.
Represent PolyNovo in industry trade associations (e.g., AdvaMed).
Stay abreast of legislative changes such as the Inflation Reduction Act or updates to the Physician Fee Schedule that impact medical device reimbursement.
Qualifications
Bachelor’s degree in Life Sciences, Economics, or Business. MPH, MBA, or PharmD preferred.
8+ years in Medical Device Market Access or Reimbursement. Experience in Wound Care, Trauma, or Aesthetics is a significant plus.
Deep understanding of US coding (CPT, ICD-10, HCPCS) and the OPPS/IPPS payment systems.
Ability to travel up to 30-40% for payer meetings and site visits.
The “PolyNovo Fit”: As a growth-stage company, we value a "player-coach" mentality—someone who can set the high-level strategy but isn’t afraid to dive into a specific claim denial or spreadsheet.
Relationship Driven: Existing relationships with CMS or major private payers (UnitedHealth, Aetna, etc.) are highly valued.
Complex Problem Solver: Ability to communicate the value of synthetic materials in a market historically dominated by biologic.
Benefits
Total compensation package consisting of base salary, bonus, and incentive plans
401k plan with company match
Comprehensive medical, dental, and vision insurance for employees and their families
Generous paid time off, 12 company holidays, and two paid Nurture days per year
Parental leave for primary and secondary caregivers
The salary range for this position is $181,600 - $216,000.
We like AI for lots of things, but we do not use it for résumé review. Your application is read by actual human beings. No automated screening tools are used in our hiring decisions.
PolyNovo fosters an environment that promotes equity, diversity, and inclusion. We recognize and value that it is the sum of our parts – our combined backgrounds, experiences and perspectives – that allow us to succeed. PolyNovo is an equal opportunity employer and provides equal employment opportunities to all applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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