Payer Account Director

This is a fully remote position, open to applicants in Alabama, +11 more states.

📋 Description

• Act as the primary liaison for Authorized Treatment Centers concerning field-related payer-access initiatives, including onboarding processes.

• Design and implement payer strategies for designated regional and national payer accounts, state Medicaid agencies, and Medicare Administrative Contractors.

• Ensure access to Orca products while executing ongoing payer segmentation and business strategy initiatives.

• Communicate scientific data, clinical practice objectives, guidelines, and expected economic program outcomes to reinforce the product's value proposition.

• Leverage Medical Science Liaison or medical-provider clinical expertise for product and disease-state presentations aimed at key decision-makers.

• Maintain favorable access, advantageous payer medical policies, and appropriate reimbursement for Orca products throughout the life cycle management of the portfolio.

• Collaborate with selected Academic Hospitals and Health Systems to facilitate patient access on an individual basis.

• Regularly engage with the Case Management team to address patient access challenges.

• Monitor KPIs and ensure dashboard accuracy to evaluate market-access results for accounts.

• Uphold Orca Bioscience’s core values, policies, procedures, and ethical standards in business.

• Undertake additional duties as assigned.

⛳️ Requirements

• Bachelor’s Degree.

• Over 12 years of relevant experience in Payer/Hospital reimbursement within the healthcare sector.

• Established relationships with Commercial Payer Medical Directors, Medicare Part A, State Medicaid, and Managed Medicaid stakeholders.

• Strong analytical abilities with a background in Payer Case rates, Payer policy formulation, and Payer Policy data tracking systems.

• Proficient problem-solving skills and experience managing multiple tasks.

• Self-motivated, results-driven, and collaborative individual with proven leadership capabilities within a complex reimbursement framework.

• Exceptional written and verbal communication skills.

• Familiarity with regulations and laws related to the protection of patient identifying information, OIG, FDA, and CMS policies regarding access.

• Capacity to work in collaboration with key internal stakeholders.

• High proficiency in Microsoft Excel, Word, and PowerPoint.

• Willingness to travel frequently during site onboarding and for ad hoc meetings (approximately 40%).

🏝️ Benefits

• Pre-IPO equity.

• Annual bonus.

• Competitive medical benefits.

• Dental benefits.

• Vision benefits.

• Paid Time Off (PTO).

• 401(k) plan.

• Life and accidental death and disability coverage.

• Parental leave benefits.

• Subsidized daily lunches and snacks at on-site locations.