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Heartflow

Payer Relations Manager - Central

RemoteUnited States only
Published
Role
Sales
Experience
Senior
Employment
Full-time
$140k–$145k/yr
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Open to US only. Set where you work from to check your eligibility.

No BS summary

Payer Relations Manager needed with 5+ years of healthcare/managed care and reimbursement experience. Must have a BS degree and understand the US payer and reimbursement environment for medical devices/diagnostics, including coverage, coding, and payment policies. Will negotiate contracts, resolve payer issues, and support market access strategy.

Core skills

reimbursementpayer relationscontract negotiation

Required skills

coveragecodingpaymentmanaged carepayer policymedical devicediagnosticscommunicationpresentation development

Optional skills

hospital contractingearly stage company experience

Required languages

English

What you'll do

  • Assume and implement assigned projects to increase covered lives and revenue.
  • Maintain current knowledge of applicable third-party reimbursement rules and regulations.
  • Serve as primary point of contact for assigned private payers.
  • Coach physicians in nuances of reimbursement advocacy for Heartflow products.
  • Lead discussions with relevant payers to reach positive coverage determinations and optimize contract terms for payment.
  • Negotiating, securing, and managing regional contracts with appropriate cross-regional and national payer accounts, including, but not limited to, managed care plans (MCOs), Accountable Care Organizations (ACOs), health systems, insurance companies and potentially, self-insured employers.
  • Support key opinion leader development from a payer perspective and provide targeted support to commercial sites to eliminate barriers to access.
  • Refine supporting materials from HQ for physician advocacy use with regional payers.
  • Support Medical Policy development as required.
  • Support the team in determining regional payer account strategy and tactics.
  • Serve as liaison between payer customers and company personnel on administrative matters.
  • Support commercialization strategy with regional sales teams and participate actively in the preparation and execution of regional field sales plans.
  • Establish critical relationships with a variety of stakeholders within their geography: health plan medical directors, select practice administrators, key opinion leaders.
  • Instill reimbursement confidence within the cardiovascular community to support FFRCT.
  • Responsible and accountable for the successful implementation within their territories of the strategic and tactical reimbursement plan for Market Access team.
  • May represent company at trade shows, scientific, or other meetings.

What they require

  • Experience closing commercial payers for coverage decisions and negotiating contracted rates for the medical device or diagnostics industry (hospital contracting experience a plus).
  • Understand the global payer and reimbursement environment, specifically as it relates to coronary artery disease diagnostic testing in the U.S.
  • Must have a solid understanding of coverage, coding, payment, and reimbursement requirements and policies.
  • Understanding of key private payer policy infrastructure, payment methodologies, coding and coverage trends.
  • Experience developing physician advocates who will testify as to the clinical utility of Heartflow products.
  • Demonstrated ability to work with multiple stakeholders in a collaborative and constructive manner.
  • Experience working in the field and supporting reimbursement needs of sales team members.
  • Excellent written and verbal communication skills, especially with presentation development.
  • Early stage company experience preferred.
  • Ability and willingness to act in accordance with regulatory compliance requirements, including but not limited to Heartflow’s quality system requirements.
  • Minimum 5+ years of health care/managed care and reimbursement industry experience.
  • BS required.
  • MBA or advanced degree preferred.

Benefits

  • Heartflow is an Equal Opportunity Employer. We are committed to a work environment that supports, inspires, and respects all individuals and do not discriminate against any employee or applicant because of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. This policy applies to every aspect of employment at Heartflow, including recruitment, hiring, training, relocation, promotion, and termination.

Heartflow is a medical technology company focused on advancing the diagnosis and management of coronary artery disease.

HealthcareMid-sizeheartflow.com/
$140k–$145k/yr