Market Access & Payer Manager
About The Position
iRhythm is seeking a Market Access & Payer Relations Manager to support the execution of payer engagement strategies, maintain relationships with key stakeholders in the payer ecosystem, and ensure optimal market access for iRhythm’s services. This individual contributor role is integral in driving reimbursement strategies, expanding coverage policies, and supporting operational initiatives to enhance patient access to iRhythm’s diagnostic services. This role will work cross-functionally with Market Access, Government Affairs, Clinical, Sales, and Revenue Cycle teams to strengthen iRhythm’s payer positioning and reimbursement frameworks.
Requirements
- Bachelor’s degree in business, healthcare administration, life sciences, or a related field required.
- 5+ years of direct experience in market access, payer relations, health policy, reimbursement, or a related field in the healthcare, medical device, or pharmaceutical industry.
- Strong understanding of commercial and government payer systems, reimbursement policies, and managed care dynamics.
- Experience with CPT, ICD-10, and HCPCS coding, as well as payer credentialing and contracting processes.
- Familiarity with prior authorization processes and payer utilization management requirements.
- Proficiency in working cross-functionally within a matrixed organization.
- Strong analytical and problem-solving skills with a data-driven approach to decision-making.
- Excellent verbal and written communication skills with the ability to present complex information effectively.
- Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) and CRM tools.
- Ability to work independently, manage multiple projects simultaneously, and meet deadlines in a fast-paced environment.
Responsibilities
- Establish and maintain strong relationships with regional and national commercial payers, government programs, and managed care organizations.
- Support contract negotiations, reimbursement rate discussions, and payer credentialing processes.
- Monitor and analyze payer policy changes, prior authorization trends, and reimbursement updates to provide strategic insights to internal teams.
- Collaborate with cross-functional teams to develop and communicate iRhythm’s value proposition to payers.
- Assist in the execution of strategies to expand coverage and streamline reimbursement pathways.
- Work with Revenue Cycle and Market Access teams to resolve payer-related coverage and reimbursement issues.
- Track and report payer interactions, policy updates, and coverage trends to identify opportunities and risks.
- Provide analytical support for payer performance metrics, reimbursement rates, and market access initiatives.
- Assist in developing educational materials, presentations, and tools for internal and external stakeholders.
- Partner with Government Affairs to track Medicare and Medicaid policy changes and assess their impact on iRhythm’s services.
- Work with Clinical and Evidence Generation teams to leverage data for payer engagement and policy advocacy.
- Support Sales and Provider Engagement teams by addressing payer-related concerns and reimbursement challenges.
- Collaborate with Legal and Compliance teams to ensure payer interactions align with regulatory requirements.
Benefits
- Estimated Pay Range $94,000.00 - $122,000.00
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
