VP, Access Strategy and Payer Engagement

Position Summary:

As VP of Access Strategy & Payer Engagement, you'll play a pivotal role in defining how our products are valued, covered, and accessed across the US payer landscape. Your primary focus will be owning the Market Access and HEOR strategy across the portfolio, building the evidence, value narratives, and payer engagement plans that drive optimal formulary positioning, reimbursement, and patient access. You'll serve as a senior relationship owner with national and regional payers and PBMs, leading coverage negotiations and proactively shaping the market ahead of launch. Partnering closely across Market Access, Commercial, Medical and executive leadership, you'll ensure access strategy is fully integrated into brand planning, financial decision-making, and the patient journey from first prescription through ongoing adherence. This is a build-and-lead role — you'll support development of a high-performing market access team leading by influence while remaining a hands-on strategic contributor, setting the standard for how access, evidence, and payer engagement come together to support the company's growth.

Principal Duties and Responsibilities include the following:

Market Access Strategy Ownership

• Own end-to-end market access strategy across the portfolio — from early lifecycle development through commercial execution — integrating access strategy, payer marketing, pricing, and contracting into one coherent plan.
• Define payer value propositions, messaging, and positioning tailored to the specific access barriers and customer dynamics of each product and indication.
• Build and continuously refine market access playbooks as the competitive landscape, category dynamics, and payer responses evolve.
• Define and monitor access performance metrics including access quality, access speed, and gross-to-net performance relative to plan.

Health Economics & Outcomes Research (HEOR) Strategy Ownership

• Own the HEOR strategic agenda in service of market access, payer engagement, and value demonstration objectives
• Define the evidence generation roadmap — including real-world evidence, burden of illness studies, comparative effectiveness research, and economic modeling — ensuring it anticipates payer evidence requirements across the product lifecycle
• Partner with Medical Affairs and Clinical teams to integrate HEOR priorities into trial design and data collection from the earliest lifecycle stages
• Develop and maintain core economic models including budget impact analyses, cost-effectiveness models, and value-based contract frameworks that underpin payer negotiations and formulary submissions
• Translate HEOR outputs into accessible, compelling value narratives for payer, provider, and HCP audiences
• Oversee the development of AMCP dossiers, value dossiers, and other payer-facing evidence packages
• Engage with external health economics thought leaders, advisory boards, and payer medical directors to shape the evidence agenda and validate value frameworks.

Pricing, Contracting & Gross-to-Net

• Inform pricing and contracting strategy across the portfolio, balancing access investment against gross-to-net discipline to maximize net trade sales.
• Flag trade-offs between access and price, ensuring access decisions reflect enterprise-level economics

Payer Account Leadership & Engagement

• Own national payer account strategy across commercial, Medicare, and Medicaid channels.
• Serve as senior relationship owner for top national and regional payers and PBMs, leading direct negotiations on coverage policy, contracting, and value-based arrangements as needed.
• Represent the company directly in health policy engagement where appropriate, including regulatory comment letters and coverage determination processes.

Launch Readiness & Market Shaping

• Build proactive market-shaping strategies that engage payers, health systems, and other stakeholders ahead of formulary decisions
• Lead payer-facing launch readiness including pull-through of coverage policy, prior authorization criteria, and claims and billing pathways.
• Identify and close access readiness gaps for pipeline assets across payer coverage, reimbursement pathways, and formulary positioning.

Policy & Competitive Monitoring

• Track the evolving policy landscape — including government pricing models, step-therapy trends, and GLOBE and IRA provisions— and translate implications into account strategy and forecasting inputs
• Maintain a current view of competitive payer coverage and contracting positions across relevant therapeutic categories
• Partner with executive leadership and Legal on policy implications as needed

Cross-Functional & Executive Partnership

• Serve as a direct strategic partner to commercial leadership, jointly owning the balance between brand growth objectives and access and GTN discipline.
• Translate brand P&L objectives into access, pricing, and contracting priorities.
• Represent payer strategy and account status to the executive team and Board as needed.
• Partner with VP, Patient & Provider Services to align field access and reimbursement support with national account strategy.
• Partner closely with Patient Services to jointly shape affordability, hub, adherence, and patient support strategies that ensure patients can access and remain on therapy.

Team Leadership & Capability Building

• Lead and develop across the Market Access team, coaching members to operate as strategic owners
• Build team capability and talent pipelines as the portfolio and organization scale
• Operate with a player-coach approach during build phases, contributing directly alongside leading the team
• Model strong leadership values and behaviors

Qualification Requirements:

• Bachelor's degree required. Advanced degree — MBA, or a healthcare-related or business field equivalent — strongly preferred.
• 12–15+ years of progressive experience in pharmaceutical or biotech market access, payer strategy, or HEOR, including at least 3 years at the ED or VP level.
• Demonstrated success building and executing multi-year market access plans and integrating access strategy into long-range financial planning and brand planning processes.
• Prior experience in Retina or ophthalmology a plus.
• Expert-level knowledge of US payer dynamics, formulary mechanics, and gross-to-net economics across commercial, Medicare, and Medicaid channels.
• Direct experience launching a Medicare Part B buy-and-bill product, including navigating miscellaneous J-code periods through permanent coding.
• Deep understanding of health economics and outcomes research methodology, including cost-effectiveness analysis, budget impact modeling, cost-utility analysis, and indirect treatment comparisons.
• Experience defining and overseeing real-world evidence (RWE) strategies, including retrospective database studies, patient-reported outcomes (PRO) research, registry studies, and burden of illness analyses
• Working knowledge of Inflation Reduction Act provisions and their downstream impact on pricing, access, and contracting strategy.
• Demonstrated ability to translate brand P&L dynamics into access investment and gross-to-net trade-off decisions. Strong understanding of how payer, pricing, and contracting strategies interact with enterprise-level financial performance.
• Proven track record negotiating directly with national payers and PBMs at a senior level on coverage policy, contracting, and value-based arrangements
• Strong influence and alignment skills with senior commercial and medical stakeholders.
• Ability to build trust and drive consensus across a matrixed organization while navigating ambiguity and organizational change.
• Previous supervisory and people management experience with a demonstrated ability to develop talent and scale team capabilities alongside portfolio growth.