Director, National Payer Accounts
Job Description
Description
About Pacira
Pacira BioSciences, Inc. is a leading provider of non-opioid pain management and regenerative health solutions dedicated to improving outcomes for health care practitioners and their patients. Our in-depth knowledge of non-opioid pain management, coupled with our passion for advancing patient care, drives our commitment to providing solutions that address unmet medical needs and improve clinical results.
Why work with us?
Rarely do you have an opportunity to do work that really matters. What drives us is our mission. What makes us successful are our people. At Pacira, you are part of an inclusive culture that fosters collaboration, growth, and innovative thinking - a place where you can make an impact and help change the standard of care in non-opioid pain management. Be part of our movement, let's pursue excellence together.
Summary:
The Director, National Payer Accounts, is responsible for negotiating coverage policies and reimbursement for designated products within assigned account areas through contracting, where necessary, and non-contracting opportunities, where possible. The incumbent will assess and diagnose the current business environment in each key account to gain positive reimbursement and coverage policies for the company portfolio with minimal restrictions. Account responsibilities include, but are not limited to: Pharmacy Benefit Managers, National/Regional Health Plans, State Medicaid, and Medicaid PBMs (i.e., Change Healthcare, Magellan, etc.).
Essential Duties & Responsibilities:
The following statements are intended to describe the general nature and level of work being performed by an individual assigned to this job. Other duties may be assigned.
- Facilitate account management by assessing protocols, contracting options, coordinating activities, and managing customer interactions through effective leadership and communication.
- Eliminate or significantly reduce barriers to access and reimbursement for portfolio of products, inclusive of drug and procedural code coverage.
- Develop and implement partnerships with cross-functional counterparts to build a comprehensive business plan for product policy adoption. This includes, but is not limited to, comprehensive account profiles, business strategies, financial models, key result areas, information systems, inventory management strategies, competitive intelligence for each account, building physician advocacy, current resources being utilized, execution of the plan, follow-up action steps to ensure compliance, and coordination/procurement of available resources.
- Establish and strengthen successful business partnerships with external partners and stakeholders, including but not limited to executive management (CEO, CFO, Director of Pharmacy Services, Contracting Directors, State Medicaid officials, and fiscal intermediaries), medical directors, key physicians, and secondary customers (pharmacists, nurses, and other healthcare professionals).
- Conduct business reviews of key accounts and the marketplace on an agreed-upon, consistent basis with the Exec Director, Market Access.
- Execute customer calls, consultations on regional accounts outside of assigned teams' key accounts, and specific skill-building initiatives with Account Managers on managed care selling to drive formulary pull-through.
- Participate in key conventions as needed (e.g., Academy of Managed Care Pharmacy (AMCP), National Association of Managed Care Physicians (NAMCP), Pharmaceutical Care Management Association (PCMA), Asembia).
- Convey an appropriate and professional image to external customers that aligns with Pacira's core values.
- Adhere strictly to Pacira's code of conduct, T/E policy, and other company policies.
- Assist with projects that require market access intelligence as needed.
Education and Experience:
- Bachelor's degree in health sciences, business/marketing, or a related field required.
- Master's degree preferred.
- Minimum of 10 years of relevant experience in the pharma/biotech industry across various roles, including market access, account director, payer marketing, sales leadership, and marketing. This experience should demonstrate increasing technical and strategic responsibility or a combination of education and relevant experiences.
- Strong understanding of the US payer environment, payer market dynamics, payer marketing principles, and the market access decision-making process.
- Proven track record of building strong relationships with key decision-makers.
- Experience in payer and pull-through activities post-contract preferred.
- Experience in medical policy, medical reimbursement and buy & bill product access preferred.
- National Account management experience with a successful track record within target accounts preferred.
- Proven success in pharma/biotech sales and sales management preferred.
- Experience in contracting, negotiating, and influencing policy with Managed Care Organizations (MCOs), Pharmacy Benefit Managers (PBMs), State Medicaid decision-makers/PBMs (e.g., Change Healthcare, Magellan), Integrated Delivery Networks (IDNs), and Health Systems preferred.
- Experience in both large and start-up companies preferred.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Knowledge, Skills, and Abilities:
- Analytical Skills: Demonstrated ability to access, analyze, and present data effectively.
- Ethical Standards: High ethical values and a strong commitment to healthcare compliance.
- Strategic Thinking and Execution: Utilizes resources efficiently to prioritize, plan, and make sound decisions regarding time allocation to drive business results. Regularly updates and adjusts business plans and strategies with urgency.
- Patient-Focused Clinical Acumen: Develops and maintains a deep understanding of relevant patient types, treatment options, and patient flow within ecosystems relevant to promoted products.
- Influence and Impact: Communicates authentically, thoughtfully, and persuasively, adhering to Pacira Principles. Conveys a professional, positive, and enthusiastic presence in all verbal and written communications.
- Personal Leadership: Embraces a growth mindset and operates with grit in a fast-paced, entrepreneurial environment. Adapts readily to change, is self-directed, pursues excellence, and holds oneself accountable to timelines and commitments.
- Teamwork and Collaboration: Seeks input from others to determine the best course of action. Proactively shares ideas and best practices with colleagues across the organization, particularly in alignment with cross-functional collaboration efforts.
- Planning and Organizing: Able to manage the administrative aspects of the role efficiently. Proficient with Microsoft Word, Excel, PowerPoint, and other relevant software.
Physical Demands:
The physical demands described here are representative of those that must me met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, talk, move between spaces, reach with hands and arms and stoop. Close vision and the need to focus on computer screen, use of hands, fingers, and wrist to type on keyboard and manipulate mouse.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Position will be based remotely. Employee will work from his/her home office setting and occasionally from a Pacira Corporate office setting.
Benefits:
- Medical, Prescription, Dental, Vision Coverage
- Flexible Spending Account & Health Savings Account with Company match
- Employee Assistance Program
- Mental Health Resources
- Disability Coverage
- Life insurance
- Critical Illness and Accident Insurance
- Legal and Identity Theft Protection
- Pet Insurance
- Fertility and Maternity Assistance
- 401(k) with company match
- Flexible Time Off (FTO) and 11 paid holidays
- Paid Parental Leave
EEO Statement: Pacira is proud to be an Equal Opportunity Employer and does not discriminate against applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age (40 or older), veteran status, disability or genetic information, or any other characteristic protected under applicable federal, state, or local law. At Pacira we are committed to intentionally cultivating a culture of inclusion where all feel welcomed and valued for their background, perspectives, and experiences. We hold one another accountable to promote trust and transparency in support of our communities and collective purpose.
Agency Disclaimer: Pacira Biosciences, Inc. (Hereafter, Pacira) does not accept unsolicited resumes from recruiters or employment agencies in response to the Pacira Careers page or a Pacira social media post. Pacira will not consider or agree to payment of any referral compensation or recruiter fee relating to unsolicited resumes. Pacira explicitly reserves the right to hire said candidate(s) without any financial obligation to the recruiter or agency. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Pacira.
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