Payer Relations Manager
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Job Description
Payer Relations Manager driving patient access to SAINT® therapy at Magnus Medical. Building strategic relationships and managing reimbursement decisions across assigned regions.
Responsibilities:
- 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.
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