National Account Executive

This is a fully remote position, open to applicants in Alabama, +3 more states.

📋 Description

• Achieve access objectives and ensure that medical coverage pathways align with FDA-approved prescribing information.

• Collaborate with Qualified Treatment Center (QTC) Account Liaisons, Marketing, Patient Support Team, Medical Value Liaisons, and other Genetix stakeholders to identify and address access barriers, ensuring patient access.

• Execute strategies and tactics to facilitate individual patient access and reimbursement (e.g., coverage, coding) across various payer segments.

• Act as the main regional contact for Genetix’s Qualified Treatment Center network regarding all market access-related matters.

• Proactively educate QTCs on state Medicaid and commercial payer coverage criteria, prior authorization (PA) processes and requirements, while addressing specific educational gaps in the treatment process and pathway.

• Build confidence in the access pathway for our therapies by utilizing published medical policies and patient approvals across the QTC network, aligning all messaging with our market access engagement strategy.

• Develop and sustain core relationships with business functions at Genetix’s QTCs, focusing on patient pull-through, including managed care contracting, CFO and revenue cycle, government affairs, billing department leads, as well as hospital quality and legal teams, gene therapy coordinators, financial coordinators, and PA and appeals support.

• Take proactive measures with QTCs to establish accurate PA submissions and minimize incomplete submissions or administrative errors.

• Regularly engage with national and regional commercial payers, fee-for-service and managed Medicaid plans, and federal payers to positively influence decision-makers in clinical criteria and medical policy.

• Present, negotiate, and execute Value Based Agreements (VBA) at the payer level to ensure timely access to FDA-approved Genetix therapies.

• Negotiate and manage value contracts with assigned payers for optimal access to Genetix products.

• Address ad hoc requests from small regional payers within the assigned territory.

• Navigate the payer ecosystem to identify delays or obstacles in the approval process, devise a plan, and implement timely resolutions.

• Provide support and strategies to QTCs to overcome delays in processes such as PA requirements, denials, and distribution channel preferences.

• Educate QTCs on considerations for case rate agreements through Letters of Intent to reduce delays.

• Connect QTCs with one another for best practice sharing or facilitate introductions with appropriate decision-makers at health plans for issue escalation and resolution.

• Identify and leverage contacts within payers, linking those stakeholders with QTCs to streamline PA review and approval processes.

• Collaborate cross-functionally within the POD team structure to ensure alignment among Genetix stakeholders, providing comprehensive support to QTCs throughout the patient journey; this includes collaboration with partners in apheresis, patient support, field medical, legal and contracting, and working closely with QTC account leads to mitigate or eliminate barriers to care during the consult and treatment phases.

• Work closely with the Medical Value Liaison (MVL) in targeted scenarios such as PA preparation, appeals, and policy and coverage influence.

• Share insights and feedback from market access stakeholders, focusing on payers and financial decision-makers at QTCs.

• Encourage and facilitate the enrollment of QTC patients into Genetix’s patient support program to enhance the patient treatment journey.

• Uphold the highest standards of professionalism and compliance in all internal and external interactions.

⛳️ Requirements

• A minimum of 10 years of experience in the biotech/pharma sector, with a bachelor’s degree required; a master’s degree in a relevant health or finance-related field is preferred.

• Proven success in engaging tertiary and quaternary clinical and research institutions and integrated delivery networks on market access issues.

• Comprehensive understanding of the current and evolving U.S. payer landscape concerning cell and gene therapies or complex therapies, from both medical and pharmacy benefit perspectives.

• Strong clinical aptitude and acumen.

• Extensive knowledge of U.S. markets, including Commercial Payers, PBMs, Stop Loss and Reinsurance, and Government Payers (FFS and Managed Medicaid, Medicare, and TRICARE).

• Established relationships with Pharmacy Directors, Medical Directors, and other key stakeholders within assigned accounts.

• Demonstrated knowledge of specialty pharmacy and buy-and-bill procurement models across commercial and government payers, with recent experience preferred.

• Expertise as a subject matter expert (SME) for assigned key payer accounts, with experience navigating complex vertically integrated organizations.

• Experience in negotiating and implementing outcomes-based or alternative payment models is preferred.

• Exceptional skills in customer business planning, tactical planning, and successful execution.

• High attention to detail with a proven ability to manage multiple competing priorities.

• Willingness to travel up to 50%.

🏝️ Benefits

• Comprehensive health, life, and disability insurance.

• Employer-matched 401(k) plan.

• Lifestyle spending account.

• Flexible time-off policy, including paid holidays and winter shutdown.

• Tuition reimbursement and loan repayment assistance.

• Paid parental leave.

• Generous commuter subsidy.

• And much more.