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Abbott · 1 month ago

Associate Manager, Clinical Trial Reimbursement

Austin, TX

Full-time

Onsite

Mid Level

$78K/yr - $156K/yr

3+ years exp

Abbott is a global healthcare leader that helps people live more fully at all stages of life. The Associate Manager of Clinical Trial Reimbursement is responsible for implementing and managing clinical trial reimbursement processes to secure Medicare and private payer reimbursement for designated clinical trials.

BiotechnologyEmergency MedicineGeneticsHealth CareHealth DiagnosticsManufacturingMedicalMedical DeviceNutritionPharmaceutical

Responsibilities

Review clinical investigative plan and payer policies (Medicare, Medicare Advantage, Medicaid and Private Payer) to provide coverage and reimbursement guidance for Investigational Device Exemption (IDE), Post Approval Study (PAS)/Post Market Study (PMS), Coverage with Evidence Development (CED), and any other Abbott sponsored trials designated for reimbursement across all therapy lines : Cardiac Rhythm Management, Electrophysiology, Heart Failure, Neuromodulation, Structural Heart and Vascular

Review, analyze for risk as needed and provide guidance and alternative approaches with Clinical Trial Agreements (CTA) and Informed Consent Forms (ICF) that support IDE, PAS/PMS and single-site clinical trials

Create study-level Medicare Coverage Analysis inclusive of coding and reimbursement recommendations to support budget creation of Abbott sponsored clinical research studies

Create study-specific reimbursement materials and oversees the preparation of study reimbursement documentation for distribution to IDE clinical study sites

Contribute to policy discussions and provide summary analysis for coverage requirements at national, local and payer specific coverage

Monitor and track payer policies to inform key stakeholders of coverage developments that affect existing and future clinical trials

Assist sites with Medicare, Medicare Advantage, Medicaid and Private Payor prior authorization, pre-determination, and appeal requests for subjects participating and enrolled in Abbott sponsored clinical trials

Assist sites with claim submission and appeal processes and other related matters requiring a specialized knowledge of Medicare, Medicaid and Private Payer reimbursement procedures and requirements

Heavy coordination with other internal teams, including Healthcare Economics, Clinical Operations, Clinical Data Science and Analytics, Marketing, Regulatory, Legal, Clinical Affairs, Research and senior management to develop and communicate recommendations regarding clinical trial reimbursement issues and implications on technology-specific US reimbursement

Ensure reimbursement and compensation processes adhere to company standards, policies and compliance

Data analysis utilizing Medicare data, procedure codes, hospital payment codes and other claims data

Basic understanding of clinical trial categorizations not limited to IDE studies, PM and categorization of A and B categorization by FDA

Remain current on developments in field(s) of expertise, applicable clinical requirements and regulatory restrictions; and a demonstrated knowledge of the company's products, markets, policies and objectives as well as industry trends. Maintains practical knowledge of current reimbursement practices

Qualification

Clinical Trial ReimbursementMedicare Coverage AnalysisCoding KnowledgeMedical Device ExperienceProject ManagementMicrosoft OfficeCommunicationInterpersonal SkillsTeam Collaboration

Required

Bachelor's degree or an equivalent combination of education and work experience

3 years' related work experience

Preferred

Bachelor's Degree in a relevant field such as public health or health economics

Five years of Medical Device company experience or relevant systems experience in a hospital/university environment

Knowledge of federal, state and industry rules and regulations governing technical aspects of reimbursement and compliance

Experience with US reimbursement that includes working knowledge of coding, Diagnostic Related Group (DRG) assignments, Ambulatory Payment Classification (APC) categorization and process

Ability to understand complex disease states and technical product information

Strong project management and prioritization skills with the ability to manage several projects simultaneously

Excellent oral and written communication skills with the ability to effectively communicate at multiple levels in the organization

Ability to perform under pressure and in a fast-paced dynamic environment

High degree of initiative, motivation and passion for the business

Excellent interpersonal skills and strong strategic management skills

Ability to work, direct, and take direction with all levels of management

Ability to perform in a diverse cross-functional team environment

Advanced personal computer skills, including experience with Microsoft Office

Experience in international reimbursement a plus