Payer Relations Manager - Central

Heartflow; Columbus (OH); On-site; USD 140,000 - 145,000; Full time

Job summary

Heartflow, located in Columbus, Ohio, is looking for a candidate to manage payer communications and projects aimed at increasing coverage for their innovative cardiac products. The role requires extensive experience in healthcare reimbursement and effective negotiation skills.

Ideal applicants will possess a BS, with a preference for advanced degrees, and are expected to work closely with healthcare professionals and stakeholders. The position offers a competitive salary ranging between $140,000-$145,000, plus variable pay.

Qualifications

• 5+ years of healthcare/managed care and reimbursement industry experience.
• Understanding of coverage, coding, payment, and reimbursement requirements.

Responsibilities

• Assume and implement assigned projects to increase covered lives and revenue.
• Lead discussions with relevant payers to reach positive coverage determinations.
• Negotiate and manage regional contracts with payer accounts.

Skills

Experience closing commercial payers for coverage decisions

Understanding of payer and reimbursement environment

Demonstrated ability to work with multiple stakeholders

Excellent written and verbal communication skills

Education

BS required

MBA or advanced degree preferred

Job description

Overview

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease, the #1 cause of death worldwide, using cutting-edge technology. The flagship product—an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis—provides a color-coded, 3D model of a patient’s coronary arteries indicating the impact blockages have on blood flow to the heart. Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMap™Analysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). Our pipeline of products is growing and so is our team; join us in helping to revolutionize precision heartcare.

Heartflow is a publicly traded company (HTFL) that has received international recognition for exceptional strides in healthcare innovation, is supported by medical societies around the world, cleared for use in the US, UK, Europe, Japan and Canada, and has been used for more than 500,000 patients worldwide.

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 for payment.
• Negotiate, secure, and manage 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.

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 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.
• 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 health care/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, 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.

Positions posted for Heartflow are not intended for or open to third party recruiters / agencies. Submission of any unsolicited resumes for these positions will be considered to be free referrals.

Heartflow has become aware of a fraud where unknown entities are posing as Heartflow recruiters in an attempt to obtain personal information from individuals as part of our application or job offer process. Before providing any personal information to outside parties, please verify the following: A) all legitimate Heartflow recruiter email addresses end with “@heartflow.com” and B) the position described is found on our careers site at www.heartflow.com/about/careers/.