National Account Manager – Medicaid, Medicare

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

📋 Description

• Oversee strategic partnerships within Durable Medical Equipment and Pharmacy Distribution sectors, encompassing PBMs, specialty and retail pharmacy networks, health plans, and access stakeholders.

• Spearhead contract negotiations, manage access strategies, and drive execution aimed at enhancing pharmacy benefit access, pull-through, and performance based on data analysis.

• Collaborate across departments with value-based selling and field sales teams to increase patient access and foster business growth.

• Lead contract negotiation and execution processes with PBMs, health plans, Medicaid plans, Medicare Advantage MCOs, and large employers.

• Create customized value propositions utilizing financial modeling, claims analytics, medical information, and health economic data.

• Obtain pharmacy formulary coverage, distribution agreements, and reimbursement pathways.

• Maintain relationships and contracts within the DME sector.

• Work alongside legal, pricing, and finance teams to develop pharmacy agreements.

• Execute pharmacy access strategies in collaboration with field sales, inside sales, marketing, and market access teams.

• Convert formulary placement into field sales tools and messaging.

• Develop and implement training, playbooks, and co-branded resources.

• Act as the primary point of contact for assigned accounts and address operational challenges.

• Establish and sustain senior-level relationships with payer organizations to influence formulary and utilization management policies.

• Represent the organization during business reviews, renegotiation cycles, and quarterly performance meetings.

• Collaborate with patient services, reimbursement, and distribution teams to enhance pharmacy fulfillment.

• Keep track of market trends, competitor access, and policy changes.

• Provide insights into market access strategy through payer mix, pharmacy benefit adoption, step-edits, and tiering analysis.

• Contribute strategically to brand planning and pricing decisions.

• Support hybrid medical and pharmacy access models.

• Collaborate with Trade & Distribution, Reimbursement, Patient Support, Legal, Marketing, and Medical Affairs.

• Partner with sales leadership to synchronize pull-through efforts across different regions.

• Serve as a subject matter expert in internal working groups and sessions focused on field-facing strategies.

⛳️ Requirements

• Bachelor’s degree, preferably in life sciences, business, or marketing, or a combination of equivalent education and relevant job experience.

• At least 12 years of experience in Market Access, National Accounts, or Managed Markets within the pharmaceutical, biotech, or medical device sectors.

• Proven success in negotiating contracts with PBMs, health plans, Medicaid Accounts, and Medicare Advantage (Part C) MCOs.

• Experience with pharmacy-first or limited distribution models is preferred.

• Familiarity with digital health and connected medical technologies is preferred.

• Comprehensive understanding of pharmacy benefits, PBM contracting, pharmacy reimbursement, Medicaid, Medicare, specialty distribution, and DME contracting.

• Strong analytical skills with the ability to transform data sets into actionable account strategies.

• Demonstrated negotiation and influencing abilities with C-suite and senior executives.

• Experience managing patient access programs, co-pay assistance models, and limited distribution networks.

• Capacity to translate formulary placement and utilization management criteria into field-ready messaging.

• Ability to navigate ambiguity in a fast-paced, evolving access model environment.

• Willingness to travel up to 50% of the time.

• Capability to work from a home office.

• Must have a valid driver’s license, appropriate auto insurance, and a clean driving record.

• Authorization to work for any employer in the U.S.; no employment visa sponsorship is available.

• Successful completion of a pre-employment drug test and background check is required.

🏝️ Benefits

• Incentive compensation and bonus opportunities.

• Medical, dental, and vision benefits available from the first day of employment.

• Health savings accounts.

• Flexible spending accounts.

• 11 paid holidays each year.

• A minimum of 20 days of paid time off, with accrual starting on day one.

• 401(k) plan with company matching contributions.

• Employee Stock Purchase Plan.

• Equipment provided for your role.

• Virtual training options available.

• Flexible remote work arrangement.

• Support for employee well-being and growth.