Reimbursement Coding & Strategy Director

Description

The Reimbursement Coding and Strategy Director leads the development and execution of U.S. coding strategies for new and existing in vitro diagnostic products. The role assesses coding pathways and gaps, defines evidence and documentation requirements, and integrates coding considerations into product development, launch readiness, and lifecycle planning. Working cross-functionally with Market Access, Medical Affairs, Regulatory Affairs, HEOR, Marketing, Government Affairs, and global teams. Alongside working with VP Market Access North America, this position translates complex coding requirements into clear recommendations, implementation plans, and customer-facing resources. The role serves as the organization’s subject-matter expert for diagnostic coding strategy and monitors changes that may affect product access, reimbursement, and commercial execution. 

Position Duties

Coding Strategy and Pathway Development

1. Lead the development of U.S. coding strategies for pipeline, launch, and on-market diagnostic products.
2. Assess available coding pathways, including CPT, PLA, HCPCS, and ICD-10 considerations, and recommend the pathway that best supports the intended use, site of service, and reimbursement objective.
3. Identify coding gaps, risks, dependencies, and decision points early in product development and translate findings into actionable recommendations for governance and product teams.
4. Develop long-range coding roadmaps, including key milestones, evidence needs, submission timing, ownership, and contingency approaches.
5. Evaluate when existing codes may be appropriate and when a new or revised code may be needed, documenting the rationale, business impact, and implementation considerations.
6. Adjust coding strategies for existing products in response to product changes, utilization patterns, coding updates, or reimbursement barriers.

Coding Applications, Evidence, and Documentation

1. Lead or coordinate the preparation of coding applications, supporting narratives, technical documentation, and evidence packages in partnership with Government Affairs, Medical Affairs, Regulatory Affairs, HEOR, and other subject-matter experts.
2. Define the clinical, technical, utilization, and economic evidence needed to support coding objectives and incorporate those requirements into evidence-generation plans.
3. Ensure coding submissions and supporting materials accurately reflect product characteristics, intended use, clinical utility, and the applicable diagnostic pathway.
4. Maintain a centralized record of coding decisions, assumptions, submission history, status, risks, and outcomes to support continuity and organizational learning.
5. Coordinate internal review and approval of coding materials in accordance with company requirements and applicable standards.
6. Represents and attends the following: AMA, ADLM, ACLA, CAP, AMP

Product Development and Launch Integration

1. Represent Market Access and coding strategy in U.S. go-to-market, pipeline, and lifecycle governance processes.
2. Integrate coding considerations into product profiles, evidence plans, launch sequencing, pricing and reimbursement planning, and commercial readiness activities.
3. Provide U.S. coding insights to global teams and adapt global market access tools to address U.S. coding requirements.
4. Partner with brand and commercial teams to develop coding-related launch plans, customer resources, internal training, and objection-handling tools.
5. Assess the operational implications of coding decisions for laboratories, providers, revenue cycle teams, sales teams, and customer support functions.

Coding Intelligence, Governance, and Enablement

1. Monitor coding publications, code-set updates, application cycles, and industry developments that may affect pipeline or on-market products.
2. Analyze potential business and access impact, communicate findings to relevant stakeholders, and recommend response plans.
3. Establish coding governance tools, decision frameworks, standard operating practices, and performance measures to improve consistency and execution.
4. Develop and maintain approved coding guides, reimbursement resources, training materials, and internal reference tools.
5. Serve as an internal expert and educator on diagnostic coding concepts, pathways, limitations, and appropriate use of coding information.
6. Collect field and customer insights related to coding barriers and use those insights to refine product-level strategies and close access gaps.
7. Perform all work in compliance with company quality procedures and standards. 
8. Perform other duties as assigned. 

Qualifications

Education and Training

• Bachelor's degree in Health Policy, Political Science, Life Sciences, Law, Public Health, Economics or Business.
• Advanced degree preferred (e.g., MBA, MPH). 

Minimum Experience

• 7+ years of healthcare experience in clinical laboratory and/or biotechnology industries. 
• 3+ years of Medicare Policy experience. 

Preferred Experience: 

• Diagnostic or Medical Devices experience preferred, along with familiarity with diagnostic technologies utilized in the laboratory setting, regulatory impacts, commercialization, and reimbursement considerations. 

Knowledge, Skills, and Abilities (KSAs)

• Demonstrated knowledge and experience of the U.S. healthcare policy and market access landscape. 
• Proven track record in building relationships and advocating for policy changes. 
• Must demonstrate strong strategy, innovation, collaboration, and analytical skills.
• A strong communicator that can lead delivery and creation of innovative and tailored communications to educate and mobilize critical stakeholders is required.
• Deep understanding of the US Market Access environment (e.g., U.S. payer system, coding, payment, coverage and stakeholder engagement). 
• Demonstrated ability to work both independently and interdependently in cross-functional (matrix) teams. 
• Proactive, self-motivated, and aware of larger business needs/implications. 
• Must be capable of prioritizing multiple priorities, model leadership behaviors, and create partnership across functions. 
• Possess the highest standards of ethics and integrity. 

Working Conditions

• Ability to remain in stationary position, often standing, for prolonged periods. 
• Ability to ascend/descend stairs, ladders, ramps, and the like.
• Domestic Travel Required: 20%. 
• International Travel Required: 0%.

The estimated salary range for this role based in the Field is between $170,000 – 269,800. This role is eligible to receive a variable annual bonus based on company, team, and individual performance per bioMerieux’s bonus program. This range may differ from ranges offered for similar positions elsewhere in the country given differences in cost of living. Actual compensation within this range is determined based on the successful candidate’s experience and will be presented in writing at the time of the offer.

In addition, bioMérieux offers a competitive Total Rewards package that may include:

·A choice of medical (including prescription), dental, and vision plans providing nationwide coverage and telemedicine options

·Company-Provided Life and Accidental Death Insurance

·Short and Long-Term Disability Insurance

·Retirement Plan including a generous non-discretionary employer contribution and employer match.

·Adoption Assistance

·Wellness Programs

·Employee Assistance Program

·Commuter Benefits

·Various voluntary benefit offerings

·Discount programs

·Parental leaves

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