Acelity Careers

Regional Managed Care Plans Manager (Remote / Virtual)

San Antonio, United States of America

Job Description

*Please note that this role can be considered for remote / virtual eligibility*

Managed Care Manager

This role is responsible for developing and leveraging relationships with multi-regional healthcare payers. This position will implement short- and long-term payer business plans that will drive corporate profitability by ensuring consistent and appropriate coverage, coding, payment of and patient access to KCI products, while being strategic, especially in light of changes in healthcare.

Primary Duties/Responsibilities:

  • This individual will assess implications of short- and long-term actions with multi-regional and Strategic payer customer segments on KCI business needs and profitability
  • This individual will develop Pricing, Product positioning and Coverage concepts, techniques and standards to move decisions within, and outside of KCI, in a direction that continues to open patient access to care with KCI products and drive revenue and profitability.
  • This individual will develop solutions to move decisions within, and outside of, KCI in a direction that continues to grow KCI business by opening patient access to care with KCI products. Implications of these solutions could impact profitability, sales force messaging (pull-through) and business direction.
  • These actions will be the result of independent interactions across KCI decision-makers, as well as Payer customers, including Medical and Purchasing Directors (clinical and administrative), case managers, and other medical management to influence access through medical policy and product profitability for KCI products. Multi-level targeting and communication is key to fully developing and partnering with Payers.
  • Develops and Implements strategies and tactics to support appropriate, product placement, reimbursement (coverage, coding, payment and patient access) across payer customers with current and pipeline products, providing trainings, reporting, etc to engage Payer.
  • Negotiates innovative and cost effective contracts that drive KCI profitability and allow access to all our products by providers and their patients. Future focus is not solely contracting on price.
  • Is responsible for outcomes in payers as measured by Revenue, Realization and Profitability.
  • Creates clear messages for dissemination to sales and marketing teams on important payer trends, reimbursement changes, and billing requirements that will affect product utilization.

Required Qualifications:

  • Bachelor's Degree
  • Three to five years of medical device or pharmaceutical sales/marketing management experience.
  • Five years of experience in developing contractual relationships in managed care organization.
  • Documented track record of success in building and maintaining product positioning with MCO’s.
  • Strong analytical skills in order to analyze and value product positioning and pricing.
  • Experience with analysis of account performance data to identify trends and prioritize growth and improvement opportunities. Other Required Skills: The Manager, Managed Care is expected to demonstrate ability with time management and self-motivation.

Preferred Qualifications:

  • Minimum 10 years medical device/pharmaceutical/biotech Sales and/or Marketing experience with at least 5 years experience with managed care.
  • Demonstrated knowledge of payer decision-making for policy, coverage, coding and patient access to KCI existing and new products
  • Exceptional communication skills that include verbal, written and presentation abilities that drive internal and external decision-making.
  • Demonstrated ability to identify opportunities and solution with problem-solving capabilities
  • Experience negotiating contracts and agreements that could impact overall corporate profitability with visionary planning and strategic mindset, leading to successful win-win outcomes.
  • Outstanding consultative and networking capabilities.
  • Excellent project management skills, with the ability to handle multiple tasks at one time.
  • Understanding of organizational behavior, corporate culture and be able to flourish in a complex and rapidly evolving workplace.
  • Skill to successfully lead partner account teams through collaboration with other members within and across sales, marketing and other business groups to improve overall effectiveness.
  • Resolve process problems and issues in collaboration with the account and KCI Advantage Center staff.

The information listed above is not a comprehensive list of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice. Any physical and mental requirements described in this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EOE AA M/F/Vet/Disability: Acelity L.P. Inc. and its subsidiaries are an equal opportunity and affirmative action employer and give consideration for employment to qualified applicants without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, age, disability, veteran status, or genetic information or any other legally protected characteristic. If you'd like more information about your EEO rights as an applicant under the law, please click here: VEVRAA Federal Contractor