Develop and execute local payer reimbursement strategies to expand coverage and payment for histotripsy across commercial insurers, Medicare/Medicaid, Medicare Advantage, and self-funded plans.
Monitor, assess, report, and respond to payer medical policy reviews, technology assessments, and payer coverage changes.
Payer claim and prior authorization issues liaison.
Maintain expertise in third-party reimbursement rules and regulations.
Serve as the primary contact and lead for account level payer-related calls, meetings, and provider advocacy.
Partner with medical societies, key opinion leaders, and patient advocacy organizations to support favorable payer policies and clinical pathway inclusion.
Develop and refine payer-facing advocacy materials and tools.
Collaborate with sales, account management, clinical, HEOR, regulatory, and reimbursement operations teams to align payer strategies.
Provide training and guidance to internal teams on payer policies and advocacy initiatives.
Track, analyze, and report on payer coverage trends and access challenges.

Bachelor’s degree in a related field;
Minimum of 8 years of experience in field reimbursement, payer relations, and market access roles.
5+ years’ field reimbursement payer and account experience including, Category III CPT Codes, physician and outpatient hospital payment, Medicare and private payer payment models.
Strong understanding of U.S. reimbursement systems and evolving reimbursement pathways for new and emerging technologies.
Proven experience influencing payer coverage and reimbursement decisions for outpatient hospital medical devices or new and emerging technologies, including those with Category III CPT codes.
Strong working knowledge of U.S. reimbursement systems, including coverage, coding, and payment across Medicare, Medicaid, commercial payers and self-funded plans.
Prior successful collaboration with medical societies, professional associations, and/or patient advocacy organizations and legislative entities.
Experience developing and communicating clinical, economic, and value-based evidence to payers and healthcare stakeholders.
Strong presentation, written, and verbal communication skills, with the ability to influence payer, provider, and C suite/executive audiences.
Understanding of key private payer policy infrastructure, payment methodologies and coding.
Demonstrated ability to work with multiple stakeholders in a collaborative manner.
Excellent written and verbal communication skills, especially with presentation development.

Reimbursement Payer Relations Manager

Key skills