Payer Relations Manager - Central

Heartflow; Chicago (IL); On-site; USD 140,000 - 145,000; Full time

Job summary

Heartflow, a medical technology company based in Chicago, is looking for a skilled professional to manage strategic relationships with payers and influence decision-making within the healthcare landscape. With a focus on advancing coronary artery disease diagnostics, the role involves collaborating with sales and implementation teams to resolve issues and foster coverage agreements.

The ideal candidate will possess a minimum of 5 years of experience in healthcare reimbursement, strong negotiation skills, and the ability to develop key stakeholder relationships. Variable pay opportunities and a supportive work environment are offered as part of the role.

Qualifications

• Minimum 5+ years of healthcare/managed-care and reimbursement industry experience.
• Experience developing physician advocates.
• Ability to negotiate and secure contracts with payers.

Responsibilities

• Identify and manage relationships with payers in assigned region.
• Resolve payer-related issues alongside the Market Access team.
• Support regional managed-care organizations.

Skills

Experience closing commercial payers

Understanding of global payer environment

Excellent communication skills

Field experience supporting reimbursement

Education

BS required; MBA or advanced degree preferred

Job description

Heartflow is a medical technology company that uses cutting‑edge AI to advance the diagnosis and management of coronary artery disease. The flagship product, the Heartflow FFRCT Analysis, is a non‑invasive cardiac test that provides a color‑coded, 3‑D model of a patient’s coronary arteries and indicates how blockages affect blood flow to the heart.

Heartflow is a publicly traded company (HTFL) clear for use in the U.S., U.K., Europe, Japan, and Canada, and has been used for more than 500,000 patients worldwide.

The individual in this position will identify, develop, and manage strategic relationships with payers and organizations that influence payer decision‑making within their assigned geographic region. They will work directly with the Market Access team, including sales, implementation, and billing specialists, to resolve payer‑related issues and support regional managed‑care organizations. The role also includes providing competitive intelligence, assisting with the local market‑access strategic plan for Heartflow’s FFRCT Analysis, and working to minimize access barriers and secure favorable coverage and reimbursement contracts for commercial payers.

Job 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.
• Negotiate, secure, and manage regional contracts with appropriate cross‑regional and national payer accounts, including managed‑care plans (MCOs), Accountable Care Organizations (ACOs), health systems, insurance companies, and 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 actively participate 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 the Market Access team.
• May represent the company at trade shows, scientific, or other meetings.

Skills Needed

• 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 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.
• Early‑stage company experience preferred.
• Ability and willingness to act in accordance with regulatory compliance requirements, including but not limited to Heartflow’s quality system requirements.

Educational Requirements & Work Experience

• Minimum 5+ years of healthcare/managed‑care and reimbursement industry experience.
• BS required; MBA or advanced degree preferred.

This position has an estimated base salary of $140,000‑$145,000 per year, with variable pay of up to $50,000 per year.

Heartflow is an Equal Opportunity Employer. We are committed to a work environment that supports, inspires, and respects all individuals and do not discriminate against any employee or applicant because of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. This policy applies to every aspect of employment at Heartflow, including recruitment, hiring, training, relocation, promotion, and termination.