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Director Reimbursement Operations

Apply now Job no: 614698
Work type: Permanent
Location: Denver, Colorado, Lone Tree, Colorado
Categories: Reimbursement, North America, Manager of Managers

Director Reimbursement Operations

Change people’s lives and love what you do!  Cochlear is the most recognized brand in hearing health care.

Human needs have always been our inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant because he saw his father struggle with hearing loss. We always start with people in mind – thinking about their needs.

For this reason, our products, services and support will continue to evolve and improve. We are by our customers’ side through the entire hearing journey, so they can experience a life full of hearing. Our employees tell us that the number one reason they enjoy working for Cochlear is the opportunity to make a difference to people’s lives and working in an organization where they can be part of bringing the mission to life each day.

About the role

As Cochlear continues to grow and service our customers, we are recruiting for a Director Reimbursement Operations for our Americas head office located in Lone Tree, Colorado! For out of state candidates, we are offering a relocation package for this role.

In alignment with our organizational principle of providing a safe work environment, employees of Cochlear are required to be fully vaccinated against COVID-19. The only allowable exceptions include qualifying medical and religious accommodation. Proof of your COVID-19 vaccination will be required prior to your start date.

 

This role is designed to act as one of the ‘managing employees’ as defined by Medicare / CMS guidelines within the reimbursement order process. You will be responsible for all aspects of the end-to-end, complex reimbursement order process, implementing operational improvements, elevating customer satisfaction and driving positive employee engagement. You’ll work collaboratively with teams across the business, including Customer Experience, Revenue Cycle Management and Logistics to ensure delivery of a remarkable experience for our customers. This leadership role is responsible for the tactical and strategic execution of the reimbursement order process for all commercial and government insurers including Medicare and multi-state Medicaid.

Key Responsibilities

  • Reimbursement Operations Planning: Creation, communication and execution of a reimbursement order experience roadmap that elevates the year-over-year performance of the team and process.
  • Reimbursement Operations Execution: Oversight and accountability of the order-to-ship reimbursement operations process including order qualification, insurance verification, physician orders and letters of medical necessity, insurance / payer authorization, release to ship.
  • Compliance management: Ensure compliance with all applicable Federal, State and Company regulatory and quality system requirements about the reimbursement operations transaction flow.
  • Lead by example. Provide direction and leadership to staff with a focus on talent development, coaching and mentoring.


Key Requirements

To add value to Cochlear in this role you'll be able to meet and demonstrate the following knowledge, skills and abilities in your application and at interview:

  • Bachelor’s Degree required
  • 10+ years of experience that includes managing healthcare reimbursement teams.
  • Must have demonstrated knowledge and proficiency in Medicare, Commercial and multi-state Medicaid payor environments, including managed care and HMO payors.
  • Must have knowledge and understanding of healthcare reimbursement regulations at both Federal and State levels across the US healthcare system.
  • Strong operational background to manage the processing functions in order to meet customer requirements while maintaining compliance with all regulations.

Physical & Mental Demands

The physical and mental demands described below are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the individual is regularly required to be in a stationary (seated/standing) position; utilize business technology for work product delivery, communicate orally and in writing with others internal or external to the organization, utilize problem solving/critical thinking skills to discern and convey information.  Specific vision abilities required by this job include ability to adjust focus. The individual is regularly required to utilize comprehension, critical thinking, communication, problem solving, organization reasoning, relating to others and discernment of items such as product specifications, procedures, and processes to customers (whether internal or external).  Influence, organization/classification of information and planning are also required.


The work environment is an office environment and is representative of those an individual encounters while performing the essential functions of this job.

In addition to the opportunity to develop your knowledge and grow professionally, we offer competitive wages and benefits.  The Target Salary Range for this role is $160,000 - $170,000 per year based upon experience as well as a bonus of 20% of base salary.

The overall benefit program includes medical, dental, vision, life and disability, pet insurance, Employee Stock Purchase Plan, 401K Matching, PTO (vacation, holidays, floating holidays, sick and volunteer time off), tuition reimbursement, maternity and paternity leave, and wellness programs.

Apply now by completing your application form online. Applicants must meet the job specific application criteria to be considered. Visit our careers site at www.cochlear.us/careers to learn more.  

Cochlear Americas is an Equal Opportunity, Affirmative Action Employer and provides equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, marital status, veteran status, or any other characteristic protected by federal, state or local lawIn addition, Cochlear will provide reasonable accommodations for qualified individuals with disabilities.  If you require accommodation with completing the online application, please contact us via web or phone at 303-264-2549.

Advertised: Mountain Daylight Time
Anticipated Application Closing:

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