Director, Payer Access
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Job Description
Director, Payer Access driving patient access initiatives across pharmaceutical company. Collaborating with cross-functional teams to secure favorable coverage and reimbursement strategies.
Responsibilities:
- Lead formulary negotiations and secure positive coverage, reimbursement, and access across assigned payer accounts
- Influence and shape clinical policy and utilization management criteria in collaboration with key payer decision-makers
- Develop comprehensive business plans for priority accounts, identifying opportunities to enhance formulary status and pull-through
- Build and maintain strategic relationships with senior leaders at national and regional payers, PBMs, and GPOs
- Prepare and lead timely, accurate, and compelling RFP responses representing the payer value proposition for the product portfolio
- Partner with internal stakeholders to ensure aligned messaging and integrated execution of market access strategies
- Analyze contract performance and leverage insights to optimize negotiation strategies and business outcomes
- Present payer value propositions and health economics information to support access discussions
- Represent the organization at major industry and payer conferences (e.g., AMCP, PCMA, Asembia)
- Ensure all activities are executed in full compliance with laws, regulations, and company policies
Requirements:
- Bachelor’s degree required; advanced degree preferred (MBA, MPH, or related field)
- 10+ years of progressive experience in the pharmaceutical or biotech industry
- Minimum 5 years of direct market access experience engaging national and regional payers
- Demonstrated success negotiating formulary access, UM criteria, contract terms, and payer RFPs
- Proven experience shaping clinical policy and driving access outcomes within payer accounts
- Strong analytical capability with experience evaluating contract performance and business impact
- Established relationships with key payer decision-makers
- Solid proficiency with Microsoft Office (PowerPoint, Excel, Word)
- Proven track record in business planning and leading strategies that expand market share and improve access.
Benefits:
- Long-Term Incentive Plan (cash plan) of 25% base salary
- Annual performance bonus target of 25% base salary
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