Payer Account Director - Southeast

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%)