Reimbursement Account Manager (Remote)
Job Description
- 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.
- 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.Â
- 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.
- Minimum 5+ years of health care/managed care and reimbursement industry experience.
- BS required. Â MBA or advanced degree preferred.
- Â Up to 40% travel
- Â Work from home/remote.
Date Posted
10/17/2022
Views
7
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