Payer Account Director / Government Accounts (PAD-GA)

Role Summary

The Payer Account Director–Government Accounts (PAD-GA) leads national payer and PBM strategies to secure optimal access and reimbursement for Vertex’s products in Federal and State Medicaid channels. The role builds relationships with key payer decision-makers, negotiates contracts, and aligns Vertex’s value with payer priorities. As the primary contact for assigned national accounts, the PAD-GA drives market access and supports sales across Business Units, collaborating with PAADs and PADs to achieve shared Medicaid access goals and enhance regional pull-through. This national role includes direct responsibility for accounts such as the VA, DoD, Medicaid state PBA pooling groups (Prime/Magellan and Optum/ChangeHealthcare), and the Indian Health Service.

Responsibilities

• Strategic Planning and Execution:
  • Develop and implement strategic account plans for assigned payers and PBMs
  • Create and execute comprehensive “mega account plans” for all assigned accounts
  • Collaborate with internal teams to align strategies and achieve access goals
• Relationship Management:
  • Build and maintain trusted relationships with key payer decision-makers, including C-suite stakeholders, Medical Directors, and Pharmacy/Industry Relations leaders
  • Serve as the primary point of contact for assigned accounts, ensuring timely issue resolution and proactive communication
• Contract Negotiation and Management:
  • Lead contract negotiations with assigned accounts to secure favorable formulary positioning and access
  • Develop business cases, conduct financial analyses, and negotiate contractual terms to maintain profitable access to Vertex products
• Market Analysis and Insights:
  • Maintain deep knowledge of Federal healthcare systems, reimbursement models, and payer operations
  • Analyze competitive dynamics and market trends to inform internal stakeholders and adjust strategies
  • Leverage data and insights to support value-based discussions and demonstrate product differentiation
• Education and Advocacy:
  • Educate accounts on disease states, unmet needs, and reimbursement pathways using approved resources
  • Collaborate with internal teams to ensure effective pull-through execution and education
• Compliance and Integrity:
  • Ensure all activities and communications comply with company policies and ethical standards
• Key Accounts:
  • Medicaid state PBA pooling groups (Prime/Magellan and Optum/ChangeHealthcare)
  • Veterans Affairs (VA)
  • Department of Defense (DoD)
  • Indian Health Service

Qualifications

• Education: Bachelor’s degree in a relevant discipline
• Experience:
  • 10+ years in the pharmaceutical/biotech industry, with 5+ years in field market access (preferably in government channels)
  • Recent experience in direct contracting with large national payers; outcomes-based agreement experience preferred
  • Expertise in both pharmacy and medical in-patient reimbursement products
  • Strong understanding of U.S. government payer landscape and managed care
• Skills:
  • Strategic, analytical, and collaborative thinking
  • Excellent oral and written communication skills
  • Proven ability to build and maintain strong customer relationships
  • Results-oriented with a track record of success
• Other Requirements:
  • Ability to thrive in a fast-paced, innovative environment
  • Willingness to travel extensively
  • Valid driver’s license