Payer Relations Manager

Summary

Join Heartflow, a medical technology company revolutionizing precision heart care, as a key member of the Market Access team. You will be responsible for developing and managing strategic relationships with payers to ensure favorable coverage and reimbursement for Heartflow's FFRCT Analysis. This role involves negotiating contracts, coaching physicians, and providing critical competitive intelligence. You will work closely with sales, implementation, and billing teams to minimize access barriers and maximize revenue. The ideal candidate possesses extensive experience in healthcare reimbursement, strong communication skills, and a proven ability to build relationships with key stakeholders. This position offers a competitive salary, variable pay, and stock options.

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. Must have a 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 but not limited to Heartflow’s quality system requirements
• Minimum 5+ years of health care/managed care and reimbursement industry experience
• BS required

Responsibilities

• Assume and implement assigned projects to increase covered lives and revenue
• Maintain current knowledge of applicable third-party reimbursement rules and regulations
• Serve as primary point of contact for assigned private payers
• Coach physicians in nuances of reimbursement advocacy for Heartflow products
• Lead discussions with relevant payers to reach positive coverage determinations and optimize contract terms for payment
• Negotiating, securing, and managing regional contracts with appropriate cross-regional and national payer accounts, including, but not limited to, managed care plans (MCOs), Accountable Care Organizations (ACOs), health systems, insurance companies and potentially, self-insured employers
• Support key opinion leader development from a payer perspective and provide targeted support to commercial sites to eliminate barriers to access
• Refine supporting materials from HQ for physician advocacy use with regional payers
• Support Medical Policy development as required
• Support the team in determining regional payer account strategy and tactics
• Serve as liaison between payer customers and company personnel on administrative matters
• Support commercialization strategy with regional sales teams and participate actively in the preparation and execution of regional field sales plans
• Establish critical relationships with a variety of stakeholders within their geography: health plan medical directors, select practice administrators, key opinion leaders
• Instill reimbursement confidence within the cardiovascular community to support FFRCT
• Responsible and accountable for the successful implementation within their territories of the strategic and tactical reimbursement plan for Market Access team
• May represent company at trade shows, scientific, or other meetings

Preferred Qualifications

• Early stage company experience preferred
• MBA or advanced degree preferred

Benefits

This position has an estimated base salary of $140,000-$145,000 per year, variable pay of up to $50,000 per year, and includes stock options