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Payer Relations Manager - Central

1 month, 3 weeks ago
United States
Full-time
Senior
Account Manager
Sales and Business Development
Apply Now
HeartFlow

HeartFlow

HeartFlow develops advanced non-invasive diagnostic solutions for coronary artery disease, utilizing AI technology to enhance visualization of coronary arteries and enable physicians to create more effective treatment plans.

Health Care Providers & Services
251-1K
Founded 2010
$793M raised
View All Jobs 2

Description

  • Identify, develop, and manage strategic relationships with payers and organizations influencing payer decisions within an assigned geographic region.
  • Serve as the primary point of contact for assigned private payers and regional managed care organizations.
  • Lead discussions with payers to secure favorable coverage determinations and optimized payment contract terms.
  • Negotiate, secure, and manage regional contracts with payer accounts, including MCOs, ACOs, health systems, insurance companies, and self-insured employers.
  • Assume and implement assigned projects to increase covered lives and revenue.
  • Maintain current knowledge of third-party reimbursement rules, regulations, policies, coding, coverage, and payment requirements.
  • Support physician advocacy efforts and coach physicians on reimbursement advocacy for Heartflow products.
  • Provide competitive intelligence and help develop local and regional market access strategy and tactical plans.
  • Support medical policy development and resolve payer-related issues in coordination with sales, implementation, and billing teams.
  • Serve as a liaison between payer customers and internal teams, and represent the company at trade shows, scientific meetings, or other events as needed.

Requirements

  • Minimum 5+ years of health care, managed care, and reimbursement industry experience.
  • Experience closing commercial payers for coverage decisions and negotiating contracted rates in the medical device or diagnostics industry; hospital contracting experience is a plus.
  • Strong understanding of the payer and reimbursement environment for coronary artery disease diagnostic testing in the U.S.
  • Solid knowledge of coverage, coding, payment, reimbursement requirements, policies, and private payer policy infrastructure.
  • Experience developing physician advocates who can testify to the clinical utility of products.
  • Demonstrated ability to work collaboratively and constructively with multiple stakeholders.
  • Experience supporting field sales teams and reimbursement needs in the field.
  • Excellent written and verbal communication skills, including presentation development.
  • BS required; MBA or advanced degree preferred.
  • Early-stage company experience preferred.
  • Ability and willingness to comply with regulatory and quality system requirements.

Benefits

  • Estimated base salary of $140,000-$145,000 per year.
  • Variable pay of up to $50,000 per year.
  • Remote work arrangement (#LI-Remote).

Interested in this position?

Apply directly on the company website

Apply Now

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