Reimbursement Payer Relations Manager - 1 East & 1 West, US

HISTOSONICS INC

18h•Remote

About The Position

HistoSonics is a commercial-stage medtech company advancing the Edison® System, a novel non-invasive sonic beam therapy based on histotripsy. Since receiving FDA De Novo grant for the non-invasive destruction of liver tumors in 2023, the company has progressed beyond initial market entry into commercial expansion, reimbursement momentum, and ongoing clinical and pipeline development. In addition to its current liver tumor indication, HistoSonics is pursuing future indications across multiple applications including kidney, pancreas, prostate, neuro, women’s health, and other significant underserved human health areas, to realize the broader potential histotripsy across multiple disease states and medical specialties. We offer an exciting work culture where cutting-edge science meets real-world application, and each team member’s contribution is important to our success in ensuring our physicians and their patients get what they need most. This is a field-based role critical to advancing payer coverage and payment to enable patient access and commercial adoption of HistoSonics’ histotripsy technology, with an initial focus on the liver indication. The Payer Relations Manager serves as the primary payer engagement lead for Histotripsy accounts and sales teams, aligning provider and patient needs, clinical evidence, and economic value narratives to influence favorable coverage and reimbursement policies. The role is responsible for identifying, developing, and managing strategic relationships with providers and other advocacy entities to support payer coverage requests, and partners closely with internal stakeholders including field reimbursement managers, prior authorization teams, sales and account managers as well as externally with providers, medical societies, legislative entities, and advocacy organizations. Working directly with the broader HistoSonics team, the position is a resource for payer-related issues.

Requirements

Bachelor’s degree in a related field
Minimum of 8 years of experience in field reimbursement, payer relations, and market access roles.
5+ years’ field reimbursement payer and account experience including, Category III CPT Codes, physician and outpatient hospital payment, Medicare and private payer payment models.
Strong understanding of U.S. reimbursement systems and evolving reimbursement pathways for new and emerging technologies.
Proven experience influencing payer coverage and reimbursement decisions for outpatient hospital medical devices or new and emerging technologies, including those with Category III CPT codes.
Strong working knowledge of U.S. reimbursement systems, including coverage, coding, and payment across Medicare, Medicaid, commercial payers and self-funded plans.
Prior successful collaboration with medical societies, professional associations, and/or patient advocacy organizations and legislative entities.
Experience developing and communicating clinical, economic, and value-based evidence to payers and healthcare stakeholders.
Strong presentation, written, and verbal communication skills, with the ability to influence payer, provider, and C suite/executive audiences.
Understanding of key private payer policy infrastructure, payment methodologies and coding.
Demonstrated ability to work with multiple stakeholders in a collaborative manner.
Excellent written and verbal communication skills, especially with presentation development.

Nice To Haves

Oncology experience a plus.

Responsibilities

Develop and execute local payer reimbursement strategies to expand coverage and payment for histotripsy across commercial insurers, Medicare/Medicaid, Medicare Advantage, and self-funded plans.
Monitor, assess, report, and respond to payer medical policy reviews, technology assessments, and payer coverage changes.
Maintain expertise in third-party reimbursement rules and regulations.
Serve as the primary contact and lead for account level payer-related calls, meetings, and provider advocacy.
Partner with medical societies, key opinion leaders, and patient advocacy organizations to support favorable payer policies and clinical pathway inclusion.
Develop and refine payer-facing advocacy materials and tools.
Collaborate with sales, account management, clinical, HEOR, regulatory, and reimbursement operations teams to align payer strategies.
Provide training and guidance to internal teams on payer policies and advocacy initiatives.
Track, analyze, and report on payer coverage trends and access challenges.