Payer Relations Manager
Magnus Medical
full-time
Posted on:
Location Type: Remote
Location: Remote • District of Columbia, Washington • 🇺🇸 United States
Visit company websiteSalary
💰 $140,000 - $150,000 per year
Job Level
Mid-LevelSenior
About the role
- Serve as the primary point of contact for assigned commercial and government payer accounts, including regional MCOs, national & federal plans, ACOs, and state Medicaid agencies.
- Lead discussions with payers to secure positive coverage determinations, pilot opportunities, or pathway inclusion for SAINT® therapy.
- Engage with key government agencies (Medicare Administrative Contractors, Medicaid departments, VA/DoD Community Care offices) to address access pathways and reimbursement alignment.
- Support development and submission of payer dossiers, coverage requests, and medical policy evidence summaries.
- Partner with the sales and field reimbursement teams to resolve payer access barriers at provider sites.
- Collaborate with internal and external stakeholders to align payer strategies across regions and inform national market access priorities.
- Provide payer insights and competitive intelligence to Market Access leadership to shape national coverage and policy strategies.
- Support commercialization and reimbursement readiness activities for SAINT® expansion.
- Coach physician and site partners on payer advocacy, prior authorization processes, and appeals pathways.
- Support development of payer-focused materials, training, and talking points for internal and external use.
- Build relationships with payer medical directors, behavioral health leaders, and influential stakeholders to promote awareness of SAINT®’s clinical and economic value.
- Monitor payer policy updates, competitive coverage shifts, and relevant state/federal reimbursement trends.
- Provide regular market intelligence reports to Market Access leadership.
- Track payer engagement metrics, coverage progress, and access outcomes for the assigned region.
Requirements
- Bachelor’s degree required; MBA, MPH, or advanced degree preferred.
- Minimum 5+ years of direct managed care, payer relations, and reimbursement experience in the medical device, digital health, or behavioral health industry.
- Proven track record in negotiating payer coverage or payment decisions for innovative therapies or technologies.
- Strong understanding of payer policy structures, coverage determination processes, and medical policy review frameworks.
- Working knowledge of U.S. healthcare reimbursement systems including Medicare, Medicaid, and commercial payer landscapes.
- Familiarity with behavioral health, neuromodulation, or CNS-related access pathways strongly preferred.
- Excellent communication, presentation, and relationship management skills.
- Ability to work collaboratively in a dynamic, cross-functional, early-stage environment.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
managed carepayer relationsreimbursementnegotiating payer coveragepayment decisionspayer policy structurescoverage determination processesmedical policy review frameworksU.S. healthcare reimbursement systemsbehavioral health
Soft skills
communicationpresentationrelationship managementcollaborationdynamic work environment
Certifications
Bachelor’s degreeMBAMPH