Exec Director, Managed Markets & Payer Strategy

San Diego, CA - USA

Monthly Salary: Not Disclosed

Posted on: 14 hours ago

Vacancies: 1 Vacancy

Job Summary

Summary:

The Executive Director Managed Markets & Payer Strategy is responsible for shaping and executing Gossamer Bios payer access strategy to ensure optimal coverage and reimbursement across Commercial Medicare and Medicaid channels. Reporting to the Vice President of Market Access this leader will oversee National Account Directors Government Pricing and Market Access operations while managing strategic vendor partnerships. The role requires deep expertise in payer contracting policy engagement and cross-functional collaboration to drive sustainable patient access and maximize enterprise value.

Essential Duties and Responsibilities

Lead the development and execution of national and regional payer access strategies across commercial Medicare and Medicaid segments.
Define contracting and negotiation strategies with PBMs MCOs IDNs and specialty pharmacies to ensure competitive access and formulary positioning.
Partner with Pricing Trade & Distribution and Legal/Compliance to design rebate chargeback and pricing frameworks aligned with gross-to-net (GTN) targets.
Develop payer value propositions budget impact models and AMCP dossiers that articulate clinical and economic differentiation.
Oversee payer account management field reimbursement strategy and customer engagement initiatives.
Partner with Marketing and Field Teams to develop payer-focused tools messaging and training to support internal and external stakeholders.
Ensure all strategies and initiatives align with legal regulatory and compliance frameworks.
Lead the development of customer segmentation messaging and campaign strategies targeting payers PBMs and large health systems.
Oversee development of HEOR strategy real-world evidence (RWE) generation and outcomes-based value demonstration.
Oversee compliance with all federal and state pricing programs including Medicaid 340B VA/FSS and Medicare Part D reporting.
Partner with Legal Compliance and Finance to ensure accurate calculation of AMP BP URA and ASP in accordance with CMS and OIG requirements.
Monitor evolving policy and legislative developments that affect drug pricing reimbursement and market access and provide strategic recommendations to senior leadership.

Education Certifications Experience

Bachelors degree required; advanced degree (MBA MPH MHA or related field) strongly preferred.
15 years of progressive experience in managed markets/market access within the pharmaceutical or biotech industry.
10 years in a leadership role of people or function.
Demonstrated expertise in U.S. payer reimbursement and pricing landscapes across both pharmacy and medical benefit channels.
Proven success in payer contracting account management and policy engagement with Commercial Medicare and Medicaid plans.
Leadership experience managing account directors and/or market access teams.
Cross-functional exposure to HEOR Sales Marketing Regulatory Finance and Business Development.
Prior experience in vendor selection and management.
Strong strategic thinking with the ability to translate corporate vision into tactical execution.
Excellent communication and negotiation skills with proven ability to influence senior payer executives and internal leadership.
Deep understanding of payer value frameworks patient access programs and reimbursement pathways.
Strategic data-driven and collaborative leader who can balance innovation with compliance rigor.
Proficiency in Microsoft Office and ability to quickly adopt new tools and technologies.
Position can be based in San Diego CA or remote.
Domestic and occasional international travel required.

Gossamer Bio is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants and complies with all applicable national state and local laws governing nondiscrimination in employment.

The expected salary range for this position is listed below. Actual pay will be determined based on experience qualifications and other job-related factors permitted by law. This position is eligible for an annual performance bonus in accordance with the terms of the applicable plan. This position also qualifies for the benefits as listed below.
Gossamer Bio offers highly competitive benefit plans and programs including medical dental and vision insurance 401(k) and 401(k) matching long-term incentive plan disability plan vacation pay sick time holiday pay and work personal and family time off in accordance with the terms of the applicable plans. For additional general information on Company benefits please visit Range

$265000$310000 USD

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Required Experience:

Director

Summary:The Executive Director Managed Markets & Payer Strategy is responsible for shaping and executing Gossamer Bios payer access strategy to ensure optimal coverage and reimbursement across Commercial Medicare and Medicaid channels. Reporting to the Vice President of Market Access this leader wil...

Summary:

Essential Duties and Responsibilities

Lead the development and execution of national and regional payer access strategies across commercial Medicare and Medicaid segments.
Define contracting and negotiation strategies with PBMs MCOs IDNs and specialty pharmacies to ensure competitive access and formulary positioning.
Partner with Pricing Trade & Distribution and Legal/Compliance to design rebate chargeback and pricing frameworks aligned with gross-to-net (GTN) targets.
Develop payer value propositions budget impact models and AMCP dossiers that articulate clinical and economic differentiation.
Oversee payer account management field reimbursement strategy and customer engagement initiatives.
Partner with Marketing and Field Teams to develop payer-focused tools messaging and training to support internal and external stakeholders.
Ensure all strategies and initiatives align with legal regulatory and compliance frameworks.
Lead the development of customer segmentation messaging and campaign strategies targeting payers PBMs and large health systems.
Oversee development of HEOR strategy real-world evidence (RWE) generation and outcomes-based value demonstration.
Oversee compliance with all federal and state pricing programs including Medicaid 340B VA/FSS and Medicare Part D reporting.
Partner with Legal Compliance and Finance to ensure accurate calculation of AMP BP URA and ASP in accordance with CMS and OIG requirements.
Monitor evolving policy and legislative developments that affect drug pricing reimbursement and market access and provide strategic recommendations to senior leadership.

Education Certifications Experience

Bachelors degree required; advanced degree (MBA MPH MHA or related field) strongly preferred.
15 years of progressive experience in managed markets/market access within the pharmaceutical or biotech industry.
10 years in a leadership role of people or function.
Demonstrated expertise in U.S. payer reimbursement and pricing landscapes across both pharmacy and medical benefit channels.
Proven success in payer contracting account management and policy engagement with Commercial Medicare and Medicaid plans.
Leadership experience managing account directors and/or market access teams.
Cross-functional exposure to HEOR Sales Marketing Regulatory Finance and Business Development.
Prior experience in vendor selection and management.
Strong strategic thinking with the ability to translate corporate vision into tactical execution.
Excellent communication and negotiation skills with proven ability to influence senior payer executives and internal leadership.
Deep understanding of payer value frameworks patient access programs and reimbursement pathways.
Strategic data-driven and collaborative leader who can balance innovation with compliance rigor.
Proficiency in Microsoft Office and ability to quickly adopt new tools and technologies.
Position can be based in San Diego CA or remote.
Domestic and occasional international travel required.