Global specialty company, 100% focused on researching and developing new medicines and improving access to care for people worldwide. Company established significant presence in over 65 countries around the globe with a broad portfolio of 12+ marketed antiretroviral medicines, multiple assets in clinical development (Phase 1-3), and a robust discovery pipeline.
Director is responsible for developing pricing & contracting strategies for all payer customer channels (e.g. managed care, Medicaid, Managed Medicaid, Medicare, ADAPs, etc) for the selected franchise, with several indications anticipated to launch over the course of the next several years. Position will include both pipeline and inline responsibilities. Pricing and reimbursement implications, payer benefit placement and coverage, as well customer experience and service delivery will all differ from the current market access environment for oral anti-retrovirals (ARVs).This position will work with the Head of US Market Access to develop strategies and tactics that support broad favorable access to the selected brands, and will have the following key responsibilities:
- Develop launch pricing and contracting strategy recommendations across all payer channels, and lead development of gross-to-net financial forecasts for launch.
- Define and/or manage inline brand pricing strategy, contracting strategy & guidelines across all payer channels.
- Develop strategies and financial models to forecast WAC, ASP, and 5iAMP, and monitor quarterly.
- Support company Governance process for pricing and payer contracts, including cross-functional consultation and evaluation with brand, legal, and contract operations.
- Collaborate with company Contract Operations team to provide input into contract development, administration, and performance.
- Lead development and review of gross-to-net financial forecasts for the franchise (short-term and long-term).
- Lead development and maintenance of brand gross-to-net financial impact modeling (public policy proposals, contract strategies, investor relations requests, etc).
- Assess US payer environmental trends and healthcare policy changes, and lead impact assessments to determine implications to provider-administered injectable ARVs.
- Lead evaluations of pharmaceutical industry pricing actions and strategies for provider-administered injectables.
- Lead independent review function for government pricing calculations and submissions, in partnership with parent company.
- Engage with payer field team to create payer insights and strategies, and to identify opportunities to enhance engagement with payer customers.
- Support payer access reporting & monitoring (coverage status, validation, coverage messaging metrics, payer access database).
- Lead, support, and develop direct report(s).
- Bachelor’s degree or equivalent in Business, Marketing, or Finance areas
- 3 – 5+ years of pharmaceutical industry experience in the market access area (payer marketing, payer contracting, Gross-to-Net finance, government pricing, etc)
- Demonstrated expertise in financial impact modeling
- Familiarity with all major payer segments, coverage decision drivers, and payer formulary access management & utilization controls
- Understanding of environmental/policy issues in the pharmaceutical industry, and trends that may influence access or performance
- Ability to lead and influence across various levels and within various functions – primarily policy, account teams, and brand marketing
- CPA, MBA, or similar advanced degree in Finance area desired, not required
- Demonstrated understanding of commercial and public payer customers (i.e. PBM, MCO, employer, Medicaid, Medicare) and the complex dynamics among key players affecting the payer customer (i.e. CMS, quality standards-setting organizations)
- Expertise in payer coverage drivers and implications for provider-administered injectables (benefit placement, coverage criteria, site of care, etc)
- Deep understanding of gross-to-net pricing and revenue analysis, including implications of pricing & contracting on different payer channels
- Familiarity with payer and provider discount arrangement structures for provider-administered injectables
- Experience with ASP and 5i AMP calculations, factors driving their results, and downstream implications
- Familiarity with payer claims adjudication for provider-administered injectables
- Provider-administered injectable product launch experience
- High level of motivation and a strong ability to find creative solutions to challenging unstructured situations
- Proven ability to operate independently and handle multiple projects with a high degree of initiative, planning, and prioritization
- Demonstrated ability to develop recommendations through logical, fact-based presentations
- Excellent communication (written & verbal), interpersonal influence and prioritization skills
- Strong business acumen and demonstrated analytical skills
- Supervisory experience
Salary up to $185K+ Annual Bonus + Incentives (RSU's)
Mid-Atlantic states (NC/VA/MD) area
Yes, full package
LT - 1299