Director, National Accounts

 This is what you will do:  

The Director, National Accounts – Kaiser Permanente is responsible for developing and implementing access strategies that support appropriate patient access to Alexion’s medicines across Kaiser Permanente’s integrated care and coverage model. This role requires deep understanding of Kaiser Permanente as an HMO, direct health care system that combines health plan financing, care delivery, medical group decision-making, pharmacy, specialty pharmacy, formulary management, and population health priorities. The Director will lead account strategy and negotiations with Kaiser Permanente stakeholders, build relationships with senior medical, pharmacy, benefit, and contracting leaders, and coordinate internal subject matter experts to communicate the clinical, economic, and patient value of Alexion’s portfolio. The Director also educates cross-functional teams on Kaiser Permanente coverage policies and regional decision-making processes, provides field insight to inform access strategy, resolves customer-specific access challenges, and engages the account for product education, pre-approval information exchange, and contract negotiations. This is a field-based role and reports to the Senior Director, Payer Account Team Lead. 

You will be responsible for:  

• Implementing Kaiser-specific access strategies that reflect Kaiser Permanente’s integrated health plan, care delivery, pharmacy, specialty pharmacy, and regional operating model to support appropriate patient access to Alexion’s medicines 

• Leading negotiations and account planning with Kaiser Permanente national and regional stakeholders to secure favorable access and contracting outcomes aligned to brand and portfolio strategy 

• Driving execution of brand access strategies across Kaiser Permanente affiliates and regions, recognizing differences in formulary, medical policy, specialty pharmacy, and site-of-care processes 

• Maintaining and fostering relationships with senior Kaiser Permanente medical, pharmacy, formulary, contracting, population health, and benefit leaders by leveraging expert knowledge of the customer’s organizational structure, clinical priorities, and evidence-based decision-making processes 

• Leveraging internal resources and subject matter experts, including HEOR, Medical, field sales, contracting, patient services, and brand teams, to communicate the value of Alexion’s medicines in ways that align with Kaiser Permanente’s emphasis on quality, affordability, total cost of care, and appropriate utilization 

• Developing holistic customer strategies that account for Kaiser Permanente’s integrated model, including health plan coverage, Permanente Medical Group clinical pathways, formulary review, specialty pharmacy operations, infusion or provider-administered drug processes, and member experience 

• Educating internal cross-functional teams on Kaiser Permanente coverage policies, regional variation, formulary processes, medical benefit management, pharmacy benefit management, utilization management, and exception pathways to enhance strategic planning and execution 

• Promoting cross-functional collaboration with internal stakeholders to align strategies and optimize access solutions for Kaiser Permanente patients, providers, and care teams 

• Developing tailored solutions for the field force and access teams to address Kaiser-specific product access, referral, authorization, reimbursement, site-of-care, coding, or care coordination challenges 

• Collaborating with market access, patient services, brand, medical, TLL, and patient advocacy colleagues to identify threats and opportunities within Kaiser Permanente and ensure coordinated execution against regional and national account priorities 

• Engaging Kaiser Permanente stakeholders to present product value, conduct disease state education for pipeline products, perform pre-approval information exchange engagements, and negotiate contract agreements in line with contract strategy and compliance requirements 

• Conducting periodic business reviews with Kaiser Permanente stakeholders to evaluate contract performance, access outcomes, policy implementation, utilization trends, mutual goals, and opportunities for improved patient access 

• Providing insights to internal stakeholders, including access strategy teams, Market Access colleagues and sales leadership on Kaiser Permanente priorities, evidence needs, regional decision-making dynamics, and emerging access risks 

• Engaging cross-functional stakeholders, including HEOR and Medical, in Kaiser Permanente meetings to ensure comprehensive, compliant, and account-relevant communication 

• Gathering information and creating analyses to strengthen the organization’s understanding of Kaiser Permanente market dynamics, integrated delivery network priorities, biosimilar and affordability strategies, utilization management approaches, competitive behavior, and potential business impacts 

You will need to have:  

• Bachelor’s Degree in a relevant area of study 

• 10+ years’ experience in Market Access in the biopharmaceutical/pharmaceutical industry 

• 5+ years’ experience in an account management role with responsibility for national payer, integrated delivery network, health system, PBM, specialty pharmacy, or vertically integrated payer customers 

• Experience in an account management role with responsibility for Kaiser Permanente, integrated delivery networks, vertically integrated payers, national payer organizations, or PBM customers 

• Established relationships or demonstrated ability to build relationships with Kaiser Permanente national and regional medical, pharmacy, formulary, contracting, and population health stakeholders 

• Experience negotiating contracts with payers, integrated delivery systems, PBMs, specialty pharmacies, or regional health plans 

• Expert knowledge of U.S. managed markets, including commercial and government payers, integrated delivery networks, medical benefit management, pharmacy benefit management, and formulary decision-making 

• Demonstrated success securing appropriate coverage for specialty medicines covered under the medical benefit and pharmacy benefit, including in organizations with integrated pharmacy, care delivery, and population health models 

• Excellent collaboration, written, and verbal communication skills, with the ability to translate complex clinical and economic evidence for payer, pharmacy, medical, and internal audiences 

• Travel requirements: Willing to travel at least 60% of the time, including significant overnight and occasional weekend travel, to support Kaiser Permanente national and regional engagement 

• Valid driver’s license and clean driving record 

• The duties of this role are generally conducted in a field environment. As is typical of a field-based role, employees must be able, with or without an accommodation, to: travel by public transportation, automobile, train, or plane; work comfortably in a clinical or payer setting; use a computer; engage in communications via phone, video, and electronic messaging; problem solve; engage in complex and non-linear thought, analysis, and dialogue; collaborate with others; and maintain general availability during standard business hours 

We would prefer you to have:  

• MBA, MPH, PharmD, or other advanced degree 

• Experience securing access for rare disease medicines within integrated delivery networks, regional health plans, or systems with centralized clinical and pharmacy decision-making 

• Strong understanding of reimbursement methodologies, prior authorization, exceptions, step therapy, formulary placement, site-of-care management, and coverage policies utilized by commercial and government payers 

• Clinical, technical, and scientific knowledge and aptitude in complex disease states and rare disease therapeutic areas 

• Experience developing and executing payer contracting strategies that account for medical benefit and pharmacy benefit coverage, formulary review, specialty pharmacy operations, biosimilar or affordability initiatives, and regional implementation dynamics 

• Experience securing rapid coverage for launches of new products and indications in organizations with centralized evidence review, regional policy implementation, and integrated clinical care pathways