Director, Strategic Payer Accounts

Job overview:  

Our Director, Strategic Payer Accounts is responsible for driving and securing formulary access and coverage for COMP360 across Medicaid payers, as well as key Regional (Commercial and Medicare) payers ahead of and through launch.

Reporting to the Senior Director, Strategic Payer Accounts, this individual is responsible for establishing and maintaining strategic and productive customer relationships, developing strategic account plans that support their efforts in translating the COMP360 value proposition into sustainable coverage wins, while partnering internally with Health Economics and Outcomes Research (HEOR), Medical Affairs, Government Affairs, and Commercial Operations to ensure payer strategies are fully executed with precision.

Location: Remote in the United States.  

Reports to: Senior Director, Strategic Payer Accounts.

Roles and responsibilities 
(Include but are not limited to): 

Strategic Payer Account Strategy and Execution

• Work closely with the Senior Director to develop and execute account strategies across Medicaid and key Regional (Commercial and Medicare) payers to drive optimal formulary positioning for COMP360 at launch and beyond
• Stay current with dynamic market forces, customer organizational changes, and policy changes at the state and federal level, that impact Compass and/or payer customers, and incorporate those variables into proposed account strategies and tactics as necessary and appropriate
• Own strategic and tactical planning and prioritization for assigned payer accounts, profiling key decision-makers including Pharmacy Directors, Medical Directors, Clinical Pharmacy and Finance leads, and P&T committee members
• Own strategic relationships with payer customers and serve as the primary interface and negotiator for coverage and access discussions
• Identify and proactively address barriers to formulary inclusion, developing tailored strategies to support timely P&T reviews and coverage policy development

Value Communication and Pull-Through

• Articulate the clinical and economic value proposition of COMP360 to payer audiences, integrating HEOR evidence, budget impact models, and real-world data to support coverage and access decisions
• Partner with the Senior Director and Finance on contracting recommendations to ensure proposals are commercially sound, aligned with government pricing compliance requirements, and GTN impacts are aligned with financial goals
• Collaborate closely with Directors of National Payer Accounts to develop and execute Regional pull-through initiatives following National formulary wins, and develop responsive strategies to address coverage challenges in complex or restricted downstream payer accounts

Cross-Functional Collaboration

• Partner closely with HEOR, Medical Affairs, Government Affairs, Sales, Patient Engagement, and Patient Experience cross-functional partners to align payer specific push-or-pull-through strategies and tactics
• For Medicaid public P&T and DUR meetings, lead and execute a multi-prong strategy:
  • Collaborate with Sales and Patient Engagement to obtain HCP testimony, in person, virtually, or in writing
  • Collaborate with HEOR and Medical to secure impactful manufacturer testimony at the meeting
  • Collaborate with Government Affairs around any relevant legislative-related tactics
  • Collaborate with Patient Experience regarding appropriate patient advocacy organization (i.e. NAMI, AfPA, etc.) support
• Collaborate with Sales, Patient Engagement, and Commercial Operations leadership on HCP-facing formulary and access update communications that enable effective Sales execution and pull through
• Represent the payer perspective internally, providing strategic guidance to leadership on coverage risks, opportunities, and competitive landscape dynamics

Candidate Profile:

• 7+ years in pharma/biotech market access, with significant direct experience in Medicaid and Regional payer account management
• Proven track record negotiating, securing, and maintaining formulary access for launch-stage (and beyond) specialty or breakthrough products; CNS/psychiatry or novel treatment modality experience is a plus
• Payer contracting experience, Including Innovative contracting (e.g. value-based, outcome-based, volume-based, cap models) is a plus
• Deep knowledge of US payer landscape, formulary decision-making processes, utilization management, and prior authorization design
• Ability to translate HEOR and health economic data into compelling value narratives for payer audiences
• Hands-on launch experience at a growth-stage biotech; comfortable working in ambiguous situations and building tools and capabilities from scratch
• Exceptional stakeholder management skills; equally credible with external payer accounts and internal cross-functional partners
• Bachelor's degree required; advanced degree in Business, Public Health, Health Economics, or Pharmacy preferred
• Mission and values-aligned team player and cross-functional leader, passionate about expanding access to mental health innovation; demonstrates Compass' values: Compassion, Boldness, Inclusion, Rigour