Payer Account Director - Southeast

Position Summary: We are seeking a highly motivated individual to join our US Payer Field team (Market Access) as an Account Director, covering the Southeast US. Key states include FL, GA, TN, KY, WV, NC, SC, AL, OK, MS, AR, LA, and part of TX. Key desired payer relationships include Aetna, FL Blue, and regional payers in these states.

The primary objective of the Payer Account Director is to secure favorable coverage and reimbursement for all Orca Bio products through regional, national, and government payers. Account Directors are responsible for formulating and executing account plans engaging with both Regional and National Payer customers and working directly with targeted Academic Hospitals/Health Systems. In collaboration with field sales team members, this role will be integral to onboarding treatment centers and supporting broad, timely patient access. The Account Director will be a subject matter expert on all access related items including payer policy, pricing communication, and authorized treatment center reimbursement. Strong collaboration skills are a must as this role will require you to engage with several cross-functional teams including Field Sales, Medical Affairs, Legal, Quality, and Marketing, as required.

Key Responsibilities

• Serves as single-point-of-contact for all Authorized Treatment Centers (ATCs) with respect to field-related payer-access engagements (including onboarding) as identified by Orca Pod
• Develop and execute Payer Strategy for assigned regional and national payer accounts, state Medicaid agencies, and Medicare Administrative Contractors to secure access to Orca products, as well as on-going payer segmentation and business strategy tactics
• Present analysis of scientific data, clinical practice goals, guidelines, and anticipated economic program outcomes to support product value proposition
• Utilize clinical expertise of Medical Science Liaisons or medical providers in delivering comprehensive product and disease state presentations to key decision makers.
• Deliver and maintain favorable access, advantageous payer medical policy, and appropriate reimbursement for Orca products at regional & national payer accounts throughout the life cycle management of Orca’s portfolio.
• Accountable for partnerships with targeted Academic Hospitals/Health Systems to ensure patient access for Orca products on a case-by-case basis, as needed
• Frequent interactions with Orca’s Case Management team to resolve patient access issues
• Track KPIs and ensure accuracy of dashboards to measure account market access results
• Must adhere to Orca Bioscience’s core values, policies, procedures, and business ethics.
• Perform miscellaneous duties as assigned.

Required Qualifications

• Bachelor’s Degree
• 12+ years related Payer/Hospital reimbursement experience in the healthcare industry
• Proven relationships with Commercial Payer Medical Directors, Medicare Part A, State Medicaid, and Managed Medicaid stakeholders
• Strong analytical skills with experience in Payer Case rates, Payer policy development, and Payer Policy data tracking tools
• Problem solving skills and multi-tasking experience are critical
• Proactive, results-oriented, collaborative, self-starter with demonstrated strong leadership skills and experience in a complex reimbursement environment
• Excellent presentation skills, both written and verbal
• Knowledge of regulations and laws governing the protection of patient identifying information, OIG, FDA, and CMS policies pertaining to access
• Must be a true team player and work collaboratively with key internal stakeholders
• High level of proficiency in Microsoft Excel, Word and Power Point is required
• Open to frequent travel during site onboarding process and ad hoc meetings (~40%)