Market Access & Payer Relations Manager

About iRhythm:

iRhythm is a leading digital healthcare company focused on redefining the way cardiac arrhythmias are clinically diagnosed. By combining wearable bio-sensing technology with powerful cloud-based data analytics and artificial intelligence capabilities, we strive to be the premier provider of ambulatory ECG monitoring. With over 4 million patients served, iRhythm is committed to innovation, improving patient outcomes, and expanding healthcare accessibility.

Position Summary:

iRhythm is seeking a Market Access & Payer Relations Manager to support the execution of payer engagement strategies, maintain relationships with key stakeholders in the payer ecosystem, and ensure optimal market access for iRhythm’s services. This individual contributor role is integral in driving reimbursement strategies, expanding coverage policies, and supporting operational initiatives to enhance patient access to iRhythm’s diagnostic services. This role will work cross-functionally with Market Access, Government Affairs, Clinical, Sales, Finance, and Revenue Cycle teams to strengthen iRhythm’s payer positioning and reimbursement frameworks.

Employment Type:

Full time

Location Type:

Information not provided

Salary:

Information not provided

Essential Job Functions:

Application Management

• Implementing and refining credentialing procedures, compliance reviews, audits, and other regulatory standards interdepartmentally.
• Maintaining credentialing records in the current database management system(s) and communicating expirable items, changes, or new additions.
• Manages a secure repository for sensitive organizational information necessary to maintain credentialing and contract alignment with payers and payer organizations.

Payer Engagement & Market Access Strategy

• Establish and maintain strong relationships with regional and national commercial payers, government programs, and managed care organizations.
• Support contract negotiations, reimbursement rate discussions, and payer credentialing processes.
• Monitor and analyze payer policy changes, prior authorization trends, and reimbursement updates to provide strategic insights to internal teams.
• Collaborate with cross-functional teams to develop and communicate iRhythm’s value proposition to payers.
• Assist in the execution of strategies to expand coverage and streamline reimbursement pathways.

Operational Support & Analytics

• Work with Revenue Cycle and Market Access teams to resolve payer-related coverage, increase process efficiencies with contract implementation, and reimbursement issues.
• Track and report payer interactions, policy updates, and coverage trends to identify opportunities and risks.
• Provide analytical support for payer performance metrics, reimbursement rates, and market access initiatives.
• Assist in developing educational materials, presentations, and tools for internal and external stakeholders.

Cross-Functional Collaboration

• Partner with Government Affairs to track Medicare and Medicaid policy changes and assess their impact on iRhythm’s services.
• Support Sales and Provider Engagement teams by addressing payer-related concerns and reimbursement challenges.
• Collaborate with Legal and Compliance teams to ensure payer interactions align with regulatory requirements.
• Monitor risk associated with SOX Oxley mitigation pertaining to the implementation and representation of payer contracts.