FIND_THE_RIGHTJOB.
At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You’ll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.
Attend and actively participate in cross-functional Revenue Cycle meetings and projects, including Denial Management and Order to Cash initiatives (e.g., benchmarking, system improvements).
Facilitate payor audits and internal Managed Markets projects related to the Revenue Cycle.
Research, document, and maintain payer requirements; educate and communicate guidelines specific to Durable Medical Equipment policies and State Mandates.
Identify, research, and resolve operational issues with payors, including Health Insurance Payment, Authorization, Licensing, Credentialing, and Contractual Guidelines.
Proactively interact with internal business units to review and finalize commercial agreements and pricing, and with external Health Plan customers to support negotiation of key contractual Terms and Conditions.
Gather and analyze payor data—including claim payments, product denials, sales orders, and profitability—to ensure contractual obligations are met.
Collaborate with and support Health Plan Solutions corporate account managers in overseeing assigned health plan operations.
Develop conclusions and recommendations, and present findings to Health Plan Solutions, Market Access, Managed Markets, and other business units across the revenue cycle.
Build collaborative relationships across revenue cycle divisions, proactively seeking opportunities to gather and produce data, identify issues, and target areas for development.
Participate in other related projects as assigned.
Less than 25% travel may be required as part of regular business duties.
Must Have: Minimum Requirements
To be considered for this role, please ensure the minimum requirements are evident on your resume.
High School Diploma or equivalent with 2+ years of relevant experience in Contracts or Pricing equivalent experience
OR
Associate's Degree with 1+ year experience
OR
Baccalaureate Degree
Nice to Have
Experience with licensing, credentialing, and accreditation for medical device manufacturers.
Knowledge of State Medicaid, CMS regulations, and Code of Federal Regulations (CFRs), particularly for Part B and Part D suppliers.
Understanding of healthcare industry systems, including the financial dynamics of managed care, health plans, and provider contractual relationships.
Working knowledge of pharmacy adjudication and operations (e.g., NDC coding, adjudication rejection handling, ship-to-soon edits).
Familiarity with government and managed government programs.
Experience in medical billing, claims processing, claims collections, or DME order processing within the healthcare industry.
Proficiency in HCPCS coding, ICD-10 coding, modifiers, and unit of measure calculations.
Industry experience in medical device, healthcare, pharmacy contracting, or technology preferred.
Ability to handle multiple diverse responsibilities in a fast-paced environment.
Excellent time management, organizational, verbal, and written communication skills.
Strong problem solving, analytical, and decision-making abilities.
Skilled at resolving conflicts in a tactful and professional manner.
Effective team player and capable individual contributor.
Demonstrated ability to manage issues through resolution while keeping all stakeholders informed.
Diabetes Business Description:
The Diabetes Operating Unit focuses on improving the lives of those within the global diabetes community. As a business, we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it. We’re committed to meeting people with diabetes where they are in their journey, always with an aim to make their lives easier. Our portfolio of innovative solutions are designed to provide customers greater freedom and better health, helping them achieve better glucose control, while spending less time managing their disease.
Click here to learn more about products.
Physical Job Requirements
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position.
The physical demands described within the Responsibilities section of 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. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role.
Medtronic offers a competitive Salary and flexible Benefits Package
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage.
The following benefits and additional compensation are available to those regular employees who work 20+ hours per week: Health, Dental and vision insurance , Health Savings Account , Healthcare Flexible Spending Account , Life insurance, Long-term disability leave , Dependent daycare spending account , Tuition assistance/reimbursement , and Simple Steps (global well-being program).
The following benefits and additional compensation are available to all regular employees: Incentive plans, 401(k) plan plus employer contribution and match , Short-term disability , Paid time off , Paid holidays , Employee Stock Purchase Plan , Employee Assistance Program , Non-qualified Retirement Plan Supplement (subject to IRS earning minimums) , and Capital Accumulation Plan (available to Vice Presidents and above, or subject to IRS earning minimums).
Regular employees are those who are not temporary, such as interns. Temporary employees are eligible for paid sick time, as required under applicable state law, and the Employee Stock Purchase Plan. Please note some of the above benefits may not apply to workers in Puerto Rico.
Further details are available at the link below:
We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.
Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 95,000+ passionate people.
We are engineers at heart— putting ambitious ideas to work to generate real solutions for real people. From the R&D lab, to the factory floor, to the conference room, every one of us experiments, creates, builds, improves and solves. We have the talent, diverse perspectives, and guts to engineer the extraordinary.
It is the policy of Medtronic to provide 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, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.
If you are applying to perform work for Medtronic, Inc. (“Medtronic”) in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which Medtronic reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment. Medtronic will consider for employment qualified job applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
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