Payer Account Associate Director

4 weeks ago

Étreux, Hauts-de-France, United States Vertex Pharmaceuticals Full time
Job Summary

The Payer Account Associate Director will serve as the lead point of contact for all account management activities within assigned accounts in a defined geography, including regional commercial Managed Care Organizations (MCOs) and state Medicaid agencies. This role will play an integral part in securing reimbursement for Vertex's entire portfolio of commercialized products. Key accounts include, but are not limited to, regional MCOs, Medicare health plans, and state Medicaid. The successful candidate will possess a broad and deep network of relationships with assigned accounts to execute the Market Access strategy. Most critically, this role is responsible for securing rapid, broad, and equitable access while managing profitability through effective contract negotiations with assigned accounts (where applicable), pulling through national account contracts with impacted regional accounts, and ensuring appropriate pharmacy and medical benefit criteria for Vertex products. Additionally, this role is accountable for keeping local Vertex teams informed on coverage and policy changes to ensure local level pull-through. The candidate will also be responsible for developing, maintaining, and executing account business plans that deliver on the described requirements.

Key Responsibilities

Deliver clinical and economic value proposition for Vertex products to key individuals within assigned regional accounts such as Pharmacy Directors, Medical Directors, Quality, Health Economics, Actuarial, and Executive level roles within assigned regional accounts.
  • Educate essential formulary decision makers on disease state, burden of illness, prevalence, and unmet need for near-term potential product launches through the use of approved Preapproval Information Exchange (PIE) materials.
  • Conduct financial analyses, develop business plans, and contracting proposals, secure contract terms approval, and negotiate contractual terms with customers across Vertex portfolio (where applicable).
  • Secure appropriate pharmacy and medical benefit criteria for entire Vertex marketed products for all assigned regional MCOs and state Medicaid.
  • Actively engage with payers to educate about Vertex's growing pipeline through PIE-approved resources.
  • Collaborate with many internal Vertex partners across multiple business units to address access-related opportunities and challenges within defined geography. Internal partners include market access strategy, legal, sales, field reimbursement, government affairs, medical, health economics, specialty pharmacy, and trade, contracting, and field operations.
  • Monitor state Medicaid policy and legislation such as drug transparency legislation and impact to Vertex.
  • Monitor state P&T and DURB product and class reviews and ensure Vertex cross-functional teams are aware of status.
  • Work closely with the public policy team to develop, update, and communicate comprehensive plans of action for state Medicaid for entire Vertex portfolio and pipeline ensuring broad and equitable access for future drug launches at launch to Vertex leadership team.
  • Actively share customer insights and educate Vertex partners across the market access organization and across Vertex business units and pull through strategy and contracts with regional accounts.
  • Exercise sound judgment and oversight to ensure integrity and compliance with company policies in all activities and communications.

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