Market Access Manager (710155)

Job Summary

Zimmer Biomet is a global medical technology leader. Our team members are part of a company with a heritage of leadership, a focus on shaping the future, and a mission dedicated to alleviating pain and improving the quality of life for people around the world.

As a member of the Global Market Access team, the Market Access Manager’s primary responsibility is to support patient access to Zimmer Biomet products and solutions through the recommendation and implementation of appropriate actions for insurance verification, prior authorization, medical necessity denials and appeals, and reimbursement. This role will work across the entire Zimmer Biomet enterprise and will communicate regularly with HCPs, payers, internal and other external stakeholders. The position will be required to keep appropriate documentation and apprise other Market Access team members as well as product and marketing groups of issues and trends noted with payers and other policy makers.

Principal Duties and Responsibilities

• Manage team performance of insurance verification, prior authorization and denial management services in support of key Zimmer Biomet products and solutions. Provide guidance to team members to assist with their understanding of payer processes and timelines, including issue resolution. • Liaison with external billing company(ies) to provide revenue cycle management guidance and resolution of internal issues regarding CD Laboratories services, to include determination of financial hardship cases and patient refunds. • Responsible and accountable for the successful implementation of payer strategies within a certain geographic territory to achieve positive coverage determinations for Zimmer Biomet products and solutions. • Stay informed on commercial and governmental payer coverage to support stakeholder efforts. Continuously collaborate within Market Access on payer issues and strategies for coverage and payment. • Organizes/leads team member training to ensure efficient completion of duty assignments and operations of the Patient Access Solutions team. • Provide and ensure excellent customer support from the Patient Access Solutions team to all patient and business contacts. • Interface with sales representatives and internal stakeholders on relevant issues and information. Participate in the education and on-going training of the sales team with regard to the scope of this function. • Provide verbal and written reports to support the ongoing operations, efficiency and effectiveness of the Patient Access Solutions program. • Safeguards and preserves the confidentiality of patient identifiable information in accordance with HIPAA Protected Health Information (PHI) policy. Ensure that proper documentation of information release and business associate status is executed before receiving HIPAA PHI. • Ensure compliance with Zimmer Biomet policies and Code of Conduct. This is not an exhaustive list of duties or functions and might not necessarily comprise all of the essential functions for purposes of the Americans with Disabilities Act.

Expected Areas of Competence

• Knowledge of U.S. healthcare reimbursement, health insurance concepts and benefit design required • Experience managing multiple projects in a highly-matrixed company (identifying tasks and resources, project timelines, communication status) required • Self-starter with demonstrated intrinsic motivation, including the ability to deliver high-quality results within strict time constraints • Excellent communication skills (writing and verbal) with the ability to communicate complex concepts in a simple manner • Exceptional analytical, critical thinking, and problem-solving skills balanced with a creative mindset • Exceptional customer service skills with the ability to work effectively in a team and build strong relationships internally and externally • Knowledge of medical terminology and medical conditions, preferably in orthopedics

Education/Experience Requirements

• Bachelor’s degree in related field (e.g., health care administration, health insurance, nursing) required • Graduate degree in health care administration, health insurance, nursing or business preferred • 5-7 years related experience required, including at 3 years of experience with revenue cycle management/insurance verification/prior authorization • Experience working with a payer or in a medical device/pharmaceutical environment preferred At least 1 year of leadership experience preferred

Travel Requirements

Less than 25%

Additional Information

EOE/M/W/Vet/Disability

At Zimmer Biomet, we believe in The Power of Us, which means that we are stronger together. We are committed to creating an environment where every team member feels included, respected, empowered, and celebrated.