Director, Specialty Pharmacy and Payer Accounts

Responsibilities:

• Own payer (health plan) commercial account relationships; engage pharmacy/medical leadership on formulary tier positioning, prior authorization, step therapy, and coverage policy.
• Monitor/respond to health plan coverage decisions (formulary, utilization management, clinical policy) and coordinate rapid responses.
• Drive specialty pharmacy (SP) pull-through performance: manage account relationships and performance scorecards (time-to-fill, dispense rates, hub handoff quality, patient persistence, REMS compliance) across SP partners.
• Translate payer access outcomes into SP pull-through priorities; connect SP performance gaps back to upstream payer access barriers.
• Coordinate enterprise messaging alignment.
• Lead regular business reviews; present portfolio performance data and align on pull-through initiatives.
• Build/maintain segment-level dashboards (formulary access status, SP dispense performance, co-pay utilization, patient access metrics).
• Identify/escalate access failures (PA denials, step therapy barriers, SP dispensing gaps) with root cause analysis and recommended responses.

Qualifications:

• Required: Bachelor’s degree; 10+ years pharmaceutical commercial experience; 4+ years payer access managed care account management or specialty pharmacy channel management; experience managing health plan/managed care accounts; experience managing specialty pharmacy accounts and driving SP pull-through against scorecards.
• Preferred: MBA/advanced degree; Director-level managed care/specialty experience at pharma/biotech; ability to link payer strategy to SP execution; strong cross-functional/enterprise track record; strong analytical skills; oncology/specialty experience; familiarity with REMS, LDD products, and specialty benefit channel mechanics.

Skills:

• Account management
• Cross-functional work
• Data to insights
• Digital fluency
• Omnichannel
• Scientific literacy

Application:

Submit resume and a brief note describing a payer or specialty pharmacy negotiation you led and the impact delivered.