Responsible for securing favorable coverage and reimbursement for Orca Bio products by engaging with payers and hospitals, ensuring patient access and navigating payer policies.
More than one million people in the United States today are fighting blood cancer. While a traditional allogeneic stem cell transplant has been the best hope for many, the transplant itself can prove fatal or lead to serious conditions, such as graft vs. host disease. Orca Bio is a late-stage biotechnology company redefining the transplant process by developing next-generation cell therapies with the goal of providing significantly better survival rates with dramatically fewer risks. With our purified, high-precision investigational cell therapies we hope to not only replace patients' blood and immune systems with healthy ones, but also restore their lives.
We are seeking a highly motivated individual to join our US Payer Field team as an Account Director, based in the west / mid-west region. The primary objective of the Payer Account Director is to secure favorable coverage and reimbursement for all Orca Bio products through regional, national, and government payers. Account Directors are responsible for formulating and executing account plans engaging with both Regional and National Payer customers and working directly with targeted Academic Hospitals/Health Systems. In collaboration with field sales team members, this role will be integral to onboarding treatment centers and supporting broad, timely patient access. The Account Director will be a subject matter expert on all access related items including payer policy, pricing communication, and authorized treatment center reimbursement. Strong collaboration skills are a must as this role will require you to engage with several cross-functional teams including Field Sales, Medical Affairs, Legal, Quality, and Marketing.
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, to secure access to ORCA-T at launch, 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-T upon launch at regional & national payer accounts and throughout its commercialization and continued life cycle management of all of Orca’s portfolio
- Accountable for partnerships with targeted Academic Hospitals/Health Systems to ensure patient access for ORCA-T on a case-by-case basis, as needed
- Frequent interactions with Orca’s Case Management team to resolve patient access issues
- Assist field representatives with reimbursement challenges
- Track KPIs and ensuring accuracy of dashboards to measure account market access results
- Must adhere to Orca's core values, policies, procedures, and business ethics
- Perform miscellaneous duties as assigned
Requirements
- Bachelor’s Degree required
- 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
- Open to frequent travel during site onboarding process and ad hoc meetings (~75%)
Who we are
We are driven by a passion for science and compassion for patients. We act with urgency to ensure our treatments are one day accessible to all who need them.
We live by our core values of passion, courage, and integrity. Excellence in our work means the chance to unlock a better quality of life for our patients, and with that comes tremendous responsibility.
We innovate on a path that hasn’t been paved. We embrace an entrepreneurial spirit and take calculated risks to achieve our mission. We aren’t afraid to ask “why not” and challenge the status quo.
We maintain a start-up culture of camaraderie and leadership by example, regardless of title.
We’re proud to be an equal opportunity employer, and recognize that celebrating our differences creates stronger, lasting solutions that better serve our team, our patients and their healthcare providers.
Notice to staffing firms
Orca Bio does not accept resumes from staffing agencies with which we do not have a written agreement and specific engagement for a particular opening. Our employment activities, inquiries and offers are managed through our HR/Talent team, and all candidates are presented through this channel only. We do not accept unsolicited resumes, and we rarely outsource recruitment.
Top Skills
Data Tracking Tools
Healthcare Regulations
Payer Policy Development
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