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Bausch Lomb

Makes eye medicines, lenses and surgical devices

Regional Manager Payor Accounts

Account ManagementUpdated on Nov 14
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree is required.
  • At least 5 years of industry experience in payor or reimbursement roles within medical devices and Part B coverage is required.
  • At least 2 years of experience in ophthalmic practice management, practice billing, revenue cycle, or public or private third-party reimbursement related to MIGS and its impact on providers, ambulatory surgery centers, and hospitals is required.
  • Ability to interpret Medicare Administrative Contractor Local Coverage Determinations and Articles related to MIGS and seek enforcement of Centers for Medicare & Medicaid Services regulations as they pertain to Medicare Advantage plans is required.
  • Experience with payor strategy, reimbursement, and account management is required.
  • Deep knowledge of commercial, Medicare, and Medicaid reimbursement structures, coding (including Current Procedural Terminology and International Classification of Diseases, 10th Revision codes), billing, and appeals processes is required.
  • Strong executive presence and stakeholder engagement skills with payors, key opinion leaders, and hospital systems are required.
  • Ability to travel extensively (30%–50%, approximately 3 nights per week) is required.
  • Applicants must be authorized to work for any employer in the United States.

Responsibilities

  • Develop and execute regional payor strategies to secure and maintain coverage, coding, and reimbursement across commercial plans, Medicare Advantage, and Medicaid as required.
  • Partner with Sales teams to educate and support customers by removing access barriers and resolving complex reimbursement challenges.
  • Conduct reimbursement seminars via videoconference or in person on local payor coverage criteria and requirements for appropriate reimbursement of Bausch + Lomb Surgical Glaucoma products.
  • Build and sustain relationships with payor medical directors, state agencies, and advocacy organizations to influence policy and coverage decisions.
  • Serve as the regional payor and reimbursement subject-matter expert for assigned payors, guiding internal teams and customers on medical device reimbursement, coding, billing, and appeals processes.
  • Understand and work with key health care stakeholders among commercial managed care regional plans, Medicare Advantage, Medicaid fee-for-service as needed, state ophthalmic medical groups, state advocacy groups, patients, providers, and other key health care stakeholder groups.
  • Establish and maintain payor relationships, including with medical directors and medical policy staff, resolve reimbursement barriers, and support appropriate and consistent payment.
  • Collaborate with colleagues in Sales, Medical Affairs, and the HUB provider to educate physicians and institutional customers about local payor policy requirements.
  • Proactively engage with medical directors, state agencies, and advocacy groups in the assigned region to build sustainable coverage pathways and support future technologies.

Desired Qualifications

  • An advanced degree in life science or business is preferred.
  • Ophthalmology experience is preferred.
  • Direct product launch experience is highly desirable.
  • Ability to work with ambiguity and effectiveness in cross-functional environments is desired.

About the Company

Bausch Lomb

Makes eye medicines, lenses and surgical devices

Bausch + Lomb develops and sells eye-health products for patients, consumers and clinicians, spanning everyday vision correction, prescription treatment and eye surgery. Its portfolio combines contact lenses and lens-care solutions with medicines for eye conditions and equipment used in cataract, retinal and refractive procedures. The company also sells surgical consumables and implanted lenses, supplying products used both at home and in clinical settings. It earns revenue through product sales across its vision care, pharmaceuticals and surgical businesses. Founded as an optical goods store in Rochester in 1853, Bausch + Lomb is headquartered in Vaughan, Ontario, with its U.S. headquarters in Bridgewater, New Jersey.

Company size
10,001+
Company stage
IPO
Headquarters
Vaughan, Canada
Founded
1853

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