Director, Medicare - Aetna/SSI

Role Summary

This role focuses on building and maintaining strategic partnerships with PBMs, GPOs and payers to ensure optimal formulary access, coverage, and reimbursement for the product portfolio. The Director oversees contract negotiations and manages relationships at the executive level.

Responsibilities

• Strategic account management: Develop and execute comprehensive, multi-year account plans for Aetna/SilverScript to achieve market access goals.
• Relationship building: Serve as the primary point of contact and build strong, high-level relationships with key PBM/GPO/Payer stakeholders, including C-suite executives, pharmacy directors, and formulary decision-makers.
• Contract negotiation: Lead complex contract negotiations with internal and external stakeholders to secure optimal formulary placement, maximize gross-to-net revenue, and manage rebate performance.
• Value proposition communication: Deliver clear and compelling clinical and economic value propositions to key account stakeholders, demonstrating how the company's products benefit their member populations.
• Cross-functional collaboration: Work closely with internal teams, including other Market Access colleagues which includes Contracting, Pricing, Access Strategy, Legal, Sales and Medical Affairs, to align strategies and execute plans effectively.
• Market intelligence: Continuously monitor the evolving PBM, GPO and managed care landscape, analyzing market trends, competitor activities, and policy changes that could impact market access.
• Performance monitoring: Analyze contracted product performance, conduct quarterly business reviews with account partners, and report key metrics to senior management.
• Pull-through strategy: Collaborate with field and national sales teams to ensure effective implementation and "pull-through" of access-driving strategies with affiliated accounts.
• Artificial Intelligence (AI): Understand and incorporate AI in all aspects of the role to ensure timely dissemination of information and to streamline both internal and external capabilities.

Qualifications

• Experience: A minimum of 10-15 years of experience in the pharmaceutical or biotech industry, with at least 5-10 years in a managed markets or national accounts role focused on PBMs.
• PBM/GPO/Payer relationships: Extensive, established relationships and a proven track record of successfully negotiating with the major accounts.
• Market access knowledge: In-depth understanding of the U.S. healthcare landscape, including the roles of PBMs/GPOs, managed care organizations, and government payers.
• Skills: Strong business acumen, analytical abilities, strategic thinking, and exceptional negotiation and presentation skills.

Education

• A Bachelor's degree is required, while an MBA or advanced degree in a related field is often preferred.

Additional Requirements

• Travel: Ability to travel frequently, often up to 50-65% of the time, to attend meetings and engage with key accounts.