National Payer Access Director – Rare-Disease Cell Therapy

Capricor Therapeutics, Inc.; San Diego (CA); Hybrid; USD 180,000 - 230,000; Full time

Job summary

Capricor Therapeutics is seeking a National Account Director to own payer access and coverage strategy for Deramiocel (CAP-1002) and related medical-benefit initiatives. This field-based role engages senior payer decision-makers and collaborates with Market Access, HEOR, Medical Affairs, and Sales to ensure timely patient access.

You will lead negotiations on coverage, coding, and contracting, navigate buy-and-bill pathways, and build senior-level payer relationships across national accounts,

Qualifications

• Bachelor's degree required; MBA/PharmD/MPH preferred.
• 10+ years of biotech/pharma U.S. Market Access experience, including 5+ years in a National Account Director or equivalent senior payer-facing role.
• Proven success securing coverage for high-cost specialty or cell/gene therapy products in the medical-benefit channel.
• Established senior-level relationships across national and regional payers, PBMs, Medicaid plans, Medicare/MACs and IDNs.
• Working knowledge of buy-and-bill economics, specialty pharmacy distribution, J-code / HCPCS coding, prior authorization workflows, and medical policy development.
• Strong analytical skills to interpret HEOR, budget impact, and value-based contracting models.
• Executive presence and ability to operate independently across senior external stakeholders.

Responsibilities

• Own the access and coverage strategy for an assigned set of national and regional payers, PBMs, and IDN accounts; develop and execute account-specific business plans aligned with Capricor's launch and access objectives.
• Lead value-based clinical, HEOR, and budget-impact discussions with medical directors, pharmacy directors, P&T committees, and policy teams to drive timely and appropriate medical policy positions.
• Navigate the buy-and-bill, medical-benefit, and specialty-pharmacy access pathways unique to infused cell therapies.
• Partner with the Market Access Leadership team on Pricing & Contracting appropriate to a rare-disease, cell therapy economics profile.
• Lead account-level negotiations on coverage, coding, utilization management, and contracting in coordination with Market Access leadership.
• Build and maintain trusted senior-level relationships with payer leadership across assigned accounts.
• Deliver compelling, compliant clinical, economic, and patient-centered presentations using AMCP dossiers, value decks, and approved access materials.
• Monitor coverage decisions, medical policy changes, and utilization management positions across assigned accounts; flag risks and opportunities in real time.
• Payer account (government & commercial) profiling, business plan creation, and strategic execution with top payer / customer accounts.
• Establish access goals, productivity measures, and ensure account plans are created and executed annually.

Skills

Market access leadership

Payer engagement

HEOR

Budget impact

Contracting

Policy development

Executive presence

Education

Bachelor's degree

MBA

PharmD

MPH

Job description

Capricor Therapeutics is seeking a National Account Director to own payer access and coverage strategy for Deramiocel (CAP-1002) and related medical-benefit initiatives. This field-based role engages senior payer decision-makers and collaborates with Market Access, HEOR, Medical Affairs, and Sales to ensure timely patient access.

You will lead negotiations on coverage, coding, and contracting, navigate buy-and-bill pathways, and build senior-level payer relationships across national accounts,