Payer Relations Manager

🔥 0 minutes ago

🌽 Illinois, Iowa, +4 more states – Remote

🌽 Illinois – Remote 🌾 Iowa – Remote ⚜️ Louisiana – Remote 🏈 Ohio – Remote ❄️ Minnesota – Remote 🎸 Tennessee – Remote

💵 $140k - $145k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Account Manager

👻 Ghost score 0%

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HeartFlow, Inc

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2010

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

HeartFlow, Inc. is a company pioneering in the field of cardiovascular diagnostics and care, utilizing advanced medical imaging and artificial intelligence. It offers a non-invasive personalized cardiac test that provides visualization of coronary arteries, allowing physicians to develop effective treatment plans for heart disease, which is the leading cause of death. HeartFlow’s technology combines human expertise and AI-powered tools to offer physicians critical insights without the need for invasive procedures, thus enhancing safety and efficiency in cardiovascular care. The company's solutions, such as the FFR CT Analysis, are widely adopted among top hospitals, delivering accurate and timely assessments of heart health.

📋 Description

• Identify, develop, and manage strategic relationships with payers and organizations influencing payer decision-making within the assigned geographic region • Work directly with the regional Market Access team, including sales, implementation, and billing specialists • Identify and resolve payer-related issues • Implement tactical plans developed by Market Access leadership • Provide competitive intelligence to leadership • Assist in developing the local market access strategic plan for Heartflow’s FFRCT Analysis • Minimize FFRCT access barriers and achieve favorable coverage policies and reimbursement contracts • Assume and implement projects to increase covered lives and revenue • Maintain knowledge of third-party reimbursement rules and regulations • Serve as primary contact for assigned private payers • Coach physicians on reimbursement advocacy • Lead payer discussions to secure positive coverage determinations and optimize payment contract terms • Negotiate, secure, and manage regional contracts with payer accounts, managed care plans, ACOs, health systems, insurance companies, and potentially self-insured employers • Support key opinion leader development and commercial-site access initiatives • Refine physician advocacy materials for regional payers • Support Medical Policy development • Support 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 regional field sales plans • Establish relationships with health plan medical directors, practice administrators, and key opinion leaders • Build reimbursement confidence within the cardiovascular community • Implement the strategic and tactical reimbursement plan within assigned territories • Represent the company at trade shows, scientific meetings, and other meetings as needed

🎯 Requirements

• Experience closing commercial payers for coverage decisions and negotiating contracted rates for the medical device or diagnostics industry (hospital contracting experience a plus) • Understand the global payer and reimbursement environment, specifically as it relates to 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 who will testify as to the clinical utility of Heartflow products • Demonstrated 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, especially with presentation development • Ability and willingness to act in accordance with regulatory compliance requirements, including Heartflow’s quality system requirements • Minimum 5+ years of health care/managed care and reimbursement industry experience • BS required • MBA or advanced degree preferred

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