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Payer Account Associate Director

Semma Therapeutics

Semma Therapeutics

Boston, MA, USA
Posted on Friday, May 31, 2024

Job Description

The Payer Accounts, Associate Director (PAAD) will serve as the lead point of contact for all account management activities within assigned accounts in a defined geography including regional commercial Managed Care Organizations (MCOs) and state Medicaid agencies. The PAAD will play an integral role in securing reimbursement for Vertex’s entire portfolio of commercialized products. Key accounts include but are not limited to regional MCOs, Medicare health plans, and state Medicaid. The PAAD will ideally possess a broad and deep network of relationships with assigned accounts to execute the Market Access strategy. Most critically, the PAAD is responsible for securing rapid, broad and equitable access while managing profitability through effective contract negotiations with assigned accounts (where applicable), pulling through national account contracts with impacted regional accounts, and ensuring appropriate pharmacy and medical benefit criteria for Vertex products. Additionally, the PAAD is accountable for keeping local Vertex teams informed on coverage and policy changes to ensure local level pull-though. Candidate will also be responsible for developing, maintaining, and executing account business plans that deliver on the described requirements.

Key Duties and Responsibilities

  • Deliver clinical and economic value proposition for Vertex products to key individuals within assigned regional accounts such as Pharmacy Directors, Medical Directors, Quality, Health Economics, Actuarial, and Executive level roles within assigned regional accounts.
  • Educate essential formulary decision makers on disease state, burden of illness, prevalence, and unmet need for near term potential product launches through use of approved Preapproval Information Exchange (PIE) materials.
  • Conduct financial analyses, develop business plans and contracting proposals, secure contract terms approval and negotiate contractual terms with customers across Vertex portfolio (where applicable).
  • Secure appropriate pharmacy and medical benefit criteria for entire Vertex marketed products for all assigned regional MCO’s and state Medicaid.
  • Actively engage with payers to educate about Vertex’s growing pipeline via PIE approved resources.
  • Collaborate with many internal Vertex partners across multiple business units to address access related opportunities and challenges within defined geography. Internal partners include market access strategy, legal, sales, field reimbursement, government affairs, medical, heath economics, specialty pharmacy and trade, contracting, and field operations.
  • Monitor state Medicaid policy and legislation such as drug transparency legislation and impact to Vertex.
  • Monitor state P&T and DURB product and class reviews and ensure Vertex cross-functional teams are aware of status.
  • Work closely with the public policy team to develop, update, and communicate comprehensive plans of action for State Medicaid for entire Vertex portfolio and pipeline ensuring broad and equitable access for future drug launches at launch to Vertex leadership team.
  • Actively share customer insights and educate Vertex partners across the market access organization and across Vertex business units and pull through strategy and contracts with regional accounts.
  • Exercise sound judgment and oversight to ensure integrity and compliance with company policies in all activities and communications.

Knowledge and Skills

  • In-depth knowledge of managed care and specialty pharmacy payer landscape
  • Established relationships with assigned accounts.
  • Ability to think strategically, analytically, and collaboratively.
  • Outstanding oral and written communication skills
  • Candidate must thrive working in a fast-paced, innovative environment while remaining flexible.
  • Experience in negotiating direct contracts with payers.
  • Proven record of success with strong results orientation and excellent customer relationship skills
  • Position requires significant travel.
    • Preferred: Candidate lives within designated geography (DC, IN, KY, OH, TN, VA).
    • Consideration will be given to candidates that live within approximately one-hour flight of designated geography.
    • Valid Driver’s License

Education and Experience

  • Bachelor’s degree in relevant discipline
  • Minimum 5-7 years' experience within the pharmaceutical or biotech industry with > 2 years in market access including specialty experience.



Pay Range:

$166,560 - $249,840

Disclosure Statement:

The range provided is based on what we believe is a reasonable estimate for the base salary pay range for this job at the time of posting. This role is eligible for an annual bonus and annual equity awards. Some roles may also be eligible for overtime pay, in accordance with federal and state requirements. Actual base salary pay will be based on a number of factors, including skills, competencies, experience, and other job-related factors permitted by law.

At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations. From medical, dental and vision benefits to generous paid time off (including a week-long company shutdown in the Summer and the Winter), educational assistance programs including student loan repayment, a generous commuting subsidy, matching charitable donations, 401(k) and so much more.

Company Information

Vertex is a global biotechnology company that invests in scientific innovation.

Vertex is committed to equal employment opportunity and non-discrimination for all employees and qualified applicants without regard to a person's race, color, sex, gender identity or expression, age, religion, national origin, ancestry, ethnicity, disability, veteran status, genetic information, sexual orientation, marital status, or any characteristic protected under applicable law. Vertex is an E-Verify Employer in the United States. Vertex will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.

Any applicant requiring an accommodation in connection with the hiring process and/or to perform the essential functions of the position for which the applicant has applied should make a request to the recruiter or hiring manager, or contact Talent Acquisition at