Payer Relations Manager - East Coast

Posted 21 Hours Ago
Be an Early Applicant
14 Locations
Senior level
Healthtech
Transforming Cardiovascular Care Through Innovation
The Role
The Payer Relations Manager at HeartFlow is responsible for managing strategic relationships with payers to optimize coverage and reimbursement for HeartFlow products. This role entails negotiating contracts, coaching physicians on reimbursement advocacy, providing market intelligence, and collaborating with various stakeholders to minimize access barriers and support the commercialization strategy.
Summary Generated by Built In

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 VC-backed company 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 400,000 patients worldwide.  

The individual will be responsible for the identification, development, and management of strategic relationships with payers and organizations that influence payer decision-making within their assigned geographic region. The person will work directly with the Market Access team including the sales, implementation, and billing specialist teams within their respective regions and will serve as a resource for identification and resolution of payer related issues. The person will be responsible for regional managed care organizations within their assigned geography. This person will also interact within a broader Market Access team and ultimately be responsible for implementation of tactical plan developed by the market access leadership team.

 In addition, this position will provide critical competitive intelligence within the market access marketplace to leadership. The individual will assist in the development of the local market access strategic plan for Heartflow’s FFRCT­ Analysis. The ultimate goal of the position is to minimize FFRCT access barriers and to achieve favorable coverage policy and reimbursement contracts for Heartflow products with commercial payers as well as support other billing and collections projects as needed. #LI-IB1; #LI-Remote

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.
  • 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.

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, and includes stock options.

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.

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The Company
Austin, TX
650 Employees
On-site Workplace
Year Founded: 2010

What We Do

Heartflow is the global leader in AI-driven coronary artery disease (CAD) management, transforming how CAD — the world’s leading cause of death — is diagnosed and treated. Our advanced technology generates personalized, precision 3D heart models from a single CT scan, providing clinicians with the clarity and confidence to deliver earlier, more effective treatments — transforming CAD into a disease that can be managed for life.

Heartflow One is the only complete, non-invasive, precision coronary care platform providing patient insights throughout the guideline-directed CCTA pathway. The AI-driven platform — including Roadmap™ Analysis, FFRCT Analysis and Plaque Analysis — is supported by the ACC/AHA Chest Pain Guideline and backed by more than 600 peer-reviewed publications.

With over 400,000 patients treated, more than 1,400 leading institutions adopting our solution, and 99.5% of U.S. lives covered — Heartflow is redefining the standard of coronary care. We're a global company, with employees across the United States, Europe and Japan. Our headquarters are in Mountain View, California, with additional offices in California, Texas, the UK, and Japan.

We believe CAD shouldn’t be a silent threat. By making it screenable, diagnosable, and manageable, we’re changing the story of CAD, empowering clinicians to save lives and giving patients more time for what matters most.

Why Work With Us

Join Us to Rewrite the Story of CAD.

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