Payer Relations Manager - Central
About The Position
The Payer Relations Manager is responsible for identifying, developing, and managing strategic relationships with payers and organizations that influence payer decision-making in the assigned region. The role works with the Market Access team—including sales, implementation, and billing specialists—to identify and resolve payer-related issues, manage regional managed care organizations, and implement tactical plans developed by Market Access leadership. The position provides competitive intelligence to leadership and helps develop Heartflow’s local market access strategy for FFRCT Analysis. Its goal is to minimize access barriers and secure favorable coverage policies and reimbursement contracts with commercial payers, while also supporting billing and collections projects. The role is remote and includes regional travel or event participation as needed.
Requirements
- At least 5 years of healthcare/managed care and reimbursement industry experience.
- Bachelor of Science degree required.
- Experience closing commercial payers for coverage decisions and negotiating contracted rates in the medical device or diagnostics industry.
- Solid understanding of the U.S. payer and reimbursement environment, particularly as it relates to coronary artery disease diagnostic testing.
- Understanding of coverage, coding, payment, and reimbursement requirements and policies.
- Understanding of private payer policy infrastructure, payment methodologies, and coding and coverage trends.
- Experience developing physician advocates who can testify to the clinical utility of Heartflow products.
- Ability to work collaboratively and constructively with multiple stakeholders.
- Experience working in the field and supporting sales team members' reimbursement needs.
- Excellent written and verbal communication skills, particularly in presentation development.
- Ability and willingness to comply with regulatory requirements, including Heartflow quality system requirements.
Nice To Haves
- Hospital contracting experience.
- Early-stage company experience.
- MBA or advanced degree.
Responsibilities
- Implement assigned projects to increase covered lives and revenue.
- Maintain current knowledge of applicable third-party reimbursement rules and regulations.
- Serve as the primary point of contact for assigned private payers.
- Coach physicians on reimbursement advocacy for Heartflow products.
- Lead payer discussions to achieve positive coverage determinations and optimize contract payment terms.
- Negotiate, secure, and manage regional contracts with cross-regional and national payer accounts, including managed care plans, Accountable Care Organizations, health systems, insurance companies, and potentially self-insured employers.
- Support payer-focused key opinion leader development and provide targeted support to commercial sites to eliminate access barriers.
- Adapt headquarters materials for physician advocacy with regional payers.
- Support medical policy development as required.
- Help determine regional payer account strategy and tactics.
- Liaise between payer customers and company personnel on administrative matters.
- Support commercialization strategy with regional sales teams and participate in preparing and executing regional field sales plans.
- Establish relationships with stakeholders in the assigned geography, including health plan medical directors, select practice administrators, and key opinion leaders.
- Build reimbursement confidence within the cardiovascular community to support FFRCT.
- Implement the Market Access team's strategic and tactical reimbursement plan in assigned territories.
- Represent the company at trade shows, scientific meetings, or other meetings as needed.
- Provide competitive intelligence to leadership and assist with local market access strategic planning.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
