Senior Payer Relations Manager - East Coast

Job Description: 

The Senior Payer Relations Manager is responsible for the identification, development, and management of strategic relationships with regional and national payers and organizations that influence payer decision-making within their assigned geographic region and/or designated key accounts.

This individual will serve as a senior leader within the Market Access organization and will drive high-impact initiatives, special projects, and complex payer engagements that materially expand covered lives and revenue.

The Senior Payer Relations Manager will work cross-functionally with Sales, Implementation, Billing, Medical Affairs, and Market Access leadership and will serve as a subject matter expert for payer strategy, coverage policy, contracting, and reimbursement optimization. This role will also provide mentorship, onboarding support, and ongoing training to new payer relations team members.

This individual will be accountable for implementing regional tactical plans, engaging with assigned key payer targets, providing competitive intelligence, and supporting development of strategic market access initiatives across HeartFlow’s product portfolio, including FFRCT, Plaque Analysis and related services. The ultimate goal of this position is to minimize access barriers and secure favorable coverage policies and reimbursement contracts with commercial payers, while supporting broader billing, collections, and revenue optimization initiatives.

Job Responsibilities:

• Lead strategy and engagement for assigned regional and national payer accounts, to achieve positive coverage determinations and optimize coverage and prior authorization terms including high-priority or complex accounts.
• Own and execute special projects that advance payer coverage, prior authorization strategy, or cross-functional access initiatives.
• Assume and implement assigned projects to increase covered lives and revenue.
• Serve as senior escalation point for complex payer-related issues within assigned geography or accounts.
• Provide critical competitive intelligence and payer landscape insights to Market Access leadership.
• Maintain current knowledge of third-party reimbursement rules, payment methodologies, coding, and coverage trends.
• Support Medical Policy development and payer evidence submissions as required.
• Assist in development and execution of local and national market access strategic plans.
• Partner with Sales, Implementation, and Field Reimbursement teams to eliminate reimbursement barriers and support commercialization strategies.
• Support regional field sales plans and actively participate in execution.
• Serve as liaison between payer customers and internal stakeholders on administrative and strategic matters.
• Coach physicians and key opinion leaders on reimbursement advocacy and payer engagement strategies.
• Serve as a mentor to new payer relations managers, including sharing best practices, negotiation strategies, and payer engagement frameworks across the team.
• May represent company at trade shows, scientific, or other meetings.

Skills Needed:

• Demonstrated success securing commercial payer coverage decisions within the medical device, diagnostics, or healthcare services industry (hospital contracting experience preferred).
• Deep understanding of the U.S. payer and reimbursement environment, including coverage, coding, payment, and reimbursement policies related to cardiovascular diagnostics.
• Strong knowledge of private payer policy infrastructure, payment methodologies, coding frameworks, and coverage trends.
• Experience developing and supporting physician advocates for payer engagement.
• Proven ability to manage complex, multi-stakeholder relationships in a collaborative and strategic manner.
• Experience supporting field-based sales organizations with reimbursement strategy.
• Excellent written, verbal, and presentation development skills.
• Ability to operate independently while leading cross-functional initiatives.
• Early-stage or high-growth company experience preferred.
• Strong leadership presence with demonstrated mentorship and team development experience.
• Ability and willingness to act in accordance with regulatory and compliance requirements, including company quality system requirements.

Educational Requirements & Work Experience: 

• Minimum 10+ years of healthcare/managed care and reimbursement industry experience required.
• BS required; MBA or advanced degree preferred.

Required Travel: Up to 80%

This position has an estimated base salary of $155,000-$170,000 per year, variable pay of up to $50,000 per year.