Key Facts

Remote From:

Full time

Senior (5-10 years)

English

Hard Skills

CPT Coding Reimbursement Regulations Direct Market Access Evidence Analysis Prospective Payment Systems Patient Education And Counseling Health Policies ICD Coding (ICD-9/ICD-10) Reimbursement Regulations Health Economics And Outcomes Research (HEOR) Prior Authorization Payment Systems Medicare Advantage Fault Coverage Claims And Litigation Management Oncology Online Communication Stakeholder Communications Presentation Training

Other Skills

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Non-Verbal Communication
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Analytical Skills
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Teamwork
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Persuasive Communication
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Relationship Building
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Coaching

HistoSonics, Inc.

About HistoSonics, Inc.

HistoSonics is a venture-backed medical device start-up company developing a non-invasive sonic beam therapy platform and procedure using the science of histotripsy. Histotripsy utilizes the pressure created by focused sound energy to liquify and destroy targeted tissue, including diseased tissue and tumors, at sub-cellular levels. The company’s new platform delivers personalized, tissue specific treatments with precision and control, and without the undesirable side effects of many of today’s interventional and surgical modalities. HistoSonics is led by a team of experienced domain experts and industry leaders with offices in Ann Arbor, Michigan and Minneapolis, MN.

Founded: 2018

Company size: 51 - 200

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Job description

HistoSonics is a commercial-stage medtech company advancing the Edison® System, a novel non-invasive sonic beam therapy based on histotripsy. Since receiving FDA De Novo grant for the non-invasive destruction of liver tumors in 2023, the company has progressed beyond initial market entry into commercial expansion, reimbursement momentum, and ongoing clinical and pipeline development. In addition to its current liver tumor indication, HistoSonics is pursuing future indications across multiple applications including kidney, pancreas, prostate, neuro, women’s health, and other significant underserved human health areas, to realize the broader potential histotripsy across multiple disease states and medical specialties.

We offer an exciting work culture where cutting-edge science meets real-world application, and each team member’s contribution is important to our success in ensuring our physicians and their patients get what they need most.

Location: Remote, Contiguous USA - 2 Positions - 1 for the Eastern 1/2 of the US, 1 for the Western 1/2 of the US

Travel: 25%

Position Summary (Why this role matters):

The Reimbursement Payer Relations Manager is a field-based role is critical to advancing payer coverage and payment to enable patient access and commercial adoption of HistoSonics’ histotripsy technology, with an initial focus on the liver indication. The Payer Relations Manager serves as the primary payer engagement lead for Histotripsy accounts and sales teams, aligning provider and patient needs, clinical evidence, and economic value narratives to influence favorable coverage and reimbursement policies. The role is responsible for identifying, developing, and managing strategic relationships with providers and other advocacy entities to support payer coverage requests, and partners closely with internal stakeholders including field reimbursement managers, prior authorization teams, sales and account managers as well as externally with providers, medical societies, legislative entities, and advocacy organizations. Working directly with the broader HistoSonics team, the position is a resource for payer-related issues.

Key Responsibilities (What you’ll do):

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.

Qualifications and Skills:

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. Oncology experience a plus.
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.

Benefits: We offer a comprehensive benefits package for full-time employees. This includes health, dental, and vision insurance, life, short-term and long-term disability insurance, 401(k), paid time off, and more.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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