Role Overview:
- Strategic Market Access leadership for late-stage investigational products and future label expansions across acute care and health system environments.
- Interface with customer organizations to optimize patient access, reimbursement, financial adoption, and operational integration.
Primary Responsibilities:
- Serve as primary corporate account lead for targeted organized customers and decision-makers for priority IDNs.
- Develop and execute national account strategies across IDNs, academic medical centers, large health systems, and individual cancer centers.
- Engage pharmacy, supply chain, finance, population health, quality, and clinical stakeholders to support access objectives.
- Lead engagement plans to improve formulary access, operational readiness, reimbursement optimization, and financial adoption.
- Support health system and organized customer contracting strategies.
- Collaborate with Pricing, Trade, and Contracting to evaluate opportunities and optimize access positioning.
- Provide strategic input on payer/provider dynamics; identify adoption barriers and develop customized solutions.
- Collaborate cross-functionally (Market Access, Sales, Medical Affairs, Trade, HEOR, Compliance, Legal, Finance, Patient Services).
Pre-Approval Information Exchange (PIE):
- Lead compliant PIE engagements for upcoming launches/label expansions.
- Deliver FDA-compliant clinical/economic/operational messaging; educate on impact, reimbursement pathways, coding, and implementation.
- Develop/present budget impact analyses, pro forma models, and economic value assessments.
- Quantify financial implications across acquisition cost, reimbursement, site-of-care, and patient outcomes.
Revenue Cycle & Reimbursement:
- Expertise in revenue cycle operations (coding/billing, DRG/APC, NTAP/pass-through, buy-and-bill, specialty/mmedical benefits, charge capture/claims).
- Consult on reimbursement optimization and operational implementation; identify and mitigate reimbursement risks.
HUB & Patient Services:
- Partner with HUB/patient support to optimize onboarding, benefit verification, prior auth support, financial assistance, and therapy access.
- Ensure stakeholders understand support services/workflows; provide feedback to improve HUB effectiveness.
Account Planning & Execution:
- Create national account plans (stakeholder mapping, opportunity identification, financial analyses, access strategies).
- Drive execution vs. account objectives, performance metrics, and pull-through initiatives.
- Monitor market/competitive/policy/reimbursement trends; maintain documentation, forecasting, and reporting.
Skills & Requirements:
- Strong payer/provider economics knowledge (inpatient and outpatient).
- Ability to influence executive stakeholders.
- Analytical, financial modeling, and presentation skills.
- Cross-functional leadership and collaboration.
Qualifications:
- Bachelorβs degree required; advanced degree (MBA/MPH/PharmD/MS or related) preferred.
- 8β12 yearsβ experience in pharma/biotech/specialty pharmacy/consulting/market access.
- Significant experience with IDNs, academic medical centers, organized health systems, and institutional customers.
- Travel as needed up to 50% (including overnight(s)); national travel required.