Primary Responsibilities
Strategic Market Access Leadership
- 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 leadership, supply chain, finance, population health, quality, and clinical stakeholders to support access objectives.
- Lead strategic 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.
- Identify barriers to adoption and develop customized solutions aligned with customer operational and financial objectives.
- Collaborate cross-functionally (Market Access, Sales, Medical Affairs, Trade, HEOR, Compliance, Legal, Finance, Patient Services) for coordinated customer engagement.
Pre-Approval Information Exchange (PIE)
- Lead compliant PIE engagements for launches/label expansions.
- Deliver value messaging within FDA/compliance guidelines.
- Educate stakeholders on product impact, reimbursement pathways, coding, and implementation planning.
- Develop/present budget impact analyses, pro forma models, and economic value assessments.
- Quantify financial implications (acquisition cost, reimbursement, site-of-care economics, infection/readmission reduction, efficiencies, outcomes).
Revenue Cycle & Reimbursement Expertise
- Provide expertise in coding/billing, DRG/APC, NTAP/pass-through, buy-and-bill, specialty pharmacy/medical benefit reimbursement, charge capture, claims adjudication.
- Advise customers on reimbursement optimization; identify risks and develop mitigation strategies.
HUB & Patient Services Collaboration
- Partner with HUB/patient support for onboarding, benefit verification, prior auth, financial assistance, and therapy access.
- Support operational workflow understanding and provide customer feedback to improve HUB effectiveness.
Skills & Requirements
- Strong payer/provider economics knowledge (inpatient/outpatient).
- Ability to engage and influence executive-level stakeholders.
- Analytical, financial modeling, and presentation skills.
- Strong cross-functional leadership and collaboration.
Qualifications
- Bachelorβs degree required; advanced degree (MBA, MPH, PharmD, MS, or related) preferred.
- 8β12+ years experience in pharma/biotech/specialty pharmacy/consulting/market access.
- Significant experience with IDNs, academic medical centers, organized health systems, and institutional customers.
- Travel up to 50% as needed (including overnight travel), with in-office locations in NJ and Chicago and assigned conferences.