Director, Managed Markets – Regional

This is a fully remote position, open to applicants in Connecticut, +8 more states.

📋 Description

• Oversee access strategy and implementation across a ten-state region in the Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, and Delaware.

• Manage a portfolio of 16 designated accounts, which includes regional commercial payers, Fee-For-Service (FFS) and managed Medicaid programs, along with associated Integrated Delivery Networks (IDNs).

• Ensure preparedness for product launches, timely reviews of formularies and policies, suitable coverage, and the resolution of access challenges.

• Cultivate and sustain senior-level relationships with regional commercial payers, Medicaid programs, integrated delivery networks, and provider-sponsored health plans.

• Direct account strategy for assigned Northeast partnerships, such as Highmark Health Plans, Independence Health Group, Point32Health, and UPMC Health Plan.

• Create and implement account-specific business strategies for the 16-account portfolio to facilitate access for approved products.

• Analyze formulary and medical policy processes, utilization management requirements, decision-makers, and geographical reach.

• Identify and tackle launch barriers prior to Pharmacy and Therapeutics (P&T) and coverage evaluations.

• Collaborate with Medical, Health Economics and Outcomes Research (HEOR), Marketing, Trade, Pricing and Contracting, Field Reimbursement, Sales, and Operations teams.

• Relay payer policy and coverage updates to field teams and assist in ensuring effective implementation following access successes.

• Stay informed about relevant state Medicaid regulations and regional market trends.

• Report directly to the Vice President of Market Access.

⛳️ Requirements

• A Bachelor’s degree (BA/BS) is required.

• A minimum of 10 years of experience in the biotech or pharmaceutical industry is necessary.

• At least five years of experience in regional payer account management is essential.

• Proven experience in rare disease launches, contracting, and implementation with regional payers, Medicaid, IDNs, and Centers of Excellence is required.

• Established connections with decision-makers at designated Northeast regional payers and IDNs, or similar organizations, are strongly preferred.

• Strong communication and interpersonal skills are vital.

• Must be capable of working independently as well as collaboratively in a team setting.

• A solid grasp of the payer sector, including Medical/Pharmacy Benefit designs, current legislation, and Medicaid (Managed/FFS) is necessary.

• Exceptional analytical abilities and the capacity to devise effective strategies in response to the evolving healthcare landscape are required.

• Excellent oral and written communication skills, along with teamwork capabilities, are essential.

• Experience in coordinating account strategies across multi-state payer organizations, affiliated health plans, provider-sponsored plans, and integrated delivery systems is needed.

• Ability to comprehend and present complex clinical data for approved indications is crucial.

• Willingness and capability to travel 50–60% of the time are required.

🏝️ Benefits

• Competitive compensation package.

• Annual performance-based bonus.

• Company equity participation.

• 401(k) plan with employer matching contributions.

• Employee Stock Purchase Program (ESPP).

• Pre-tax commuter benefits for transit and parking.

• Referral bonus for successful candidate placements.

• Subsidized lunch and parking for in-office workdays.

• Comprehensive medical, dental, and vision coverage fully paid by the employer for you and your dependents.

• Health Savings Account (HSA) with annual employer contributions.

• Flexible Spending Accounts (FSA) available.

• Benefits for fertility and family planning.

• Enhanced mental health support, including therapy and coaching resources.

• Hybrid work model offering flexibility.

• Generous “take-what-you-need” paid time off policy along with company-paid holidays.

• Comprehensive paid medical and parental leave.

• Opportunities for skill development and internal mobility.

• Career advancement through consistent feedback, ongoing education, and professional development programs via LinkedIn Learning, LifeLabs, and BetterUp Coaching.

• Financial incentives, peer recognition, and growth opportunities.