Payer Account Director - Southeast

More than one million people in the United States today are fighting blood cancer. While a traditional allogeneic stem cell transplant has been the best hope for many, the transplant itself can prove fatal or lead to serious conditions, such as graft vs. host disease. Orca Bio is a commercial-stage biotechnology company redefining the transplant process by developing next-generation cell therapies with the goal of providing significantly better survival rates with dramatically fewer risks. With our purified, high-precision cell therapies we hope to not only replace patients' blood and immune systems with healthy ones, but also restore their lives.

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.

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.

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%)