Payer Relations Manager - Central

The role

The Payer Relations Manager identifies and manages strategic relationships with payers and organizations in an assigned geographic region. This person works with the Market Access team to minimize access barriers and achieve favorable coverage and reimbursement contracts.

What you will do

• Implement assigned projects to increase covered lives and revenue
• Maintain knowledge of third-party reimbursement rules and regulations
• Serve as primary point of contact for assigned private payers
• Coach physicians in reimbursement advocacy for Heartflow products
• Lead discussions with payers to reach positive coverage determinations and optimize contract terms
• Negotiate and manage regional contracts with managed care plans, ACOs, health systems, and insurance companies
• Support key opinion leader development and provide support to commercial sites
• Refine supporting materials for physician advocacy use
• Support Medical Policy development
• Support commercialization strategy and regional field sales plans

Required qualifications

• Experience closing commercial payers for coverage decisions and negotiating contracted rates for the medical device or diagnostics industry
• Understand the global payer and reimbursement environment for coronary artery disease diagnostic testing in the U.S.
• 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
• 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
• Ability and willingness to act in accordance with regulatory compliance requirements
• Minimum 5+ years of health care/managed care and reimbursement industry experience
• BS required

Nice to have

• hospital contracting experience
• Early stage company experience
• MBA or advanced degree

About the company

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease using AI-driven technology. It is a publicly traded company cleared for use in the US, UK, Europe, Japan and Canada.