Director/Senior Director, Government Accounts

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Design and implement pre-launch and launch-phase access strategies for Medicaid FFS and Managed Medicaid, establishing Stoke’s credibility with state agencies prior to FDA approval.

• Act as the primary relationship manager and strategic liaison for state Medicaid pharmacy and medical directors, DUR/P&T board members, and Managed Medicaid MCO leaders in key states.

• Maintain comprehensive knowledge of account-level policies, state drug review processes, competitive landscapes, decision-making timelines, and state priorities that affect access.

• Create multi-year state Medicaid access plans that forecast policy changes, IRA pricing dynamics, and competitive shifts, balancing state-specific tactical execution with a national access strategy.

• Proactively engage with state Medicaid medical and pharmacy directors to obtain informal billing guidance, coverage letters, or favorable fee-for-service payment decisions before a permanent J code assignment.

• Track AMP-based reimbursement benchmarks, Medicaid Upper Payment Limits (UPLs), and state-specific drug fee schedules to provide payers with precise, transparent pricing narratives that facilitate appropriate reimbursement under the medical benefit.

• Keep abreast of federal and state Medicaid policy developments—including CMS guidance, CMCS informational bulletins, state plan amendments (SPAs), and 1115/1915 waiver activities—and interpret their implications for brand access strategy.

• Inform government payers about clinical and economic value in frameworks that resonate with state Medicaid budget and policy decision-makers.

• Train Stoke’s patient services and field reimbursement teams on navigating the miscellaneous J code environment at launch, including NDC crosswalk requirements and Medicaid-specific billing protocols.

• Serve as the internal expert on Medicaid reimbursement dynamics for medical benefit products associated with a miscellaneous J code (J3490/J3590) while awaiting the assignment of a permanent, product-specific code.

• Facilitate cross-functional collaboration with Policy, Advocacy, HEOR, Reimbursement, Trade & Distribution, and Marketing teams to further access goals and account-level execution.

• Coordinate pull-through initiatives with Stoke’s field teams, patient services, and reimbursement teams to ensure that coverage decisions lead to patient access.

• Distill complex CMS guidance, state legislative changes, and IRA pricing updates into clear, actionable implications for the business, effectively communicating from field teams to executive leadership.

• Engage sincerely with the Dravet syndrome patient and caregiver community and integrate community insights into government payer interactions in a compelling and compliant manner.

• Conduct all government account interactions in strict compliance with company SOPs, OIG guidelines, PhRMA Code, the Anti-Kickback Statute, and relevant federal and state Medicaid regulations.

• Navigate the unique complexities of a groundbreaking disease-modifying ASO therapy with no prior Medicaid coverage precedent, identifying creative and compliant pathways to access.

⛳️ Requirements

• Bachelor’s degree required; advanced degree (MBA, PharmD, MPH) highly preferred.

• 15+ years in the pharma/biotech sector; at least 8 years in government or Medicaid payer account management.

• Demonstrated success in achieving favorable formulary and coverage outcomes for high-cost rare or specialty products within state Medicaid programs.

• Experience in pre-launch government payer strategy—not solely in maintaining established access.

• Proven ability to navigate and assist in the creation of medical benefit policy with Medicaid accounts.

• Practical experience in managing the miscellaneous J code environment (J3490/J3590) within Medicaid, including educating payers on NDC crosswalk requirements, claims-level billing guidance, and collaboration with FRMs and specialty distribution in a Medicaid context.

• Experience in launching products for rare pediatric or rare neurological diseases; CNS or epilepsy payer experience is a significant advantage.

• Knowledge of 340B program intersections for rare disease products and compliance with duplicate discount regulations.

• Familiarity with Medicaid disability transition pathways (SSI/SSDI) for pediatric-onset neurological disease populations.

• Background at a company establishing its commercial infrastructure for the first time—startup or early commercial-stage biotech experience is desirable.

🏝️ Benefits

• Medical, dental, and vision insurance

• Life insurance

• Long- and short-term disability insurance

• Paid parental leave

• A 401K plan with company match

• Unlimited vacation time

• Tuition assistance

• Participation in our Employee Stock Purchase Program (ESPP)