Senior National Payer Access Director (Remote)

Remote; San Francisco (CA); Remote; USD 180,000 - 280,000; Full time

Job summary

Capricor Therapeutics is seeking a National Account Director to own payer access and coverage strategy for national and regional payers, PBMs, and IDNs for Deramiocel. The role partners with Market Access, Medical Affairs, HEOR, Sales, and Patient Advocacy to translate the value proposition into coverage decisions for a high-cost, rare-disease cell therapy.

The position requires 10+ years in biotech/pharma market access with 5+ years in a senior payer-facing role, and established relationships

Qualifications

• Bachelor's degree required; advanced degree (MBA, PharmD, MPH, or related) 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.
• Demonstrated success securing coverage for high-cost specialty, rare disease, or cell / gene therapy products in the medical-benefit channel.
• Established senior-level relationships across national and regional commercial 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, including 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 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.
• Partner with Trade & Patient Services to ensure smooth coverage navigation, prior authorization, and case management for patients in the assigned geography.
• Partner with Sales, Medical Affairs, and MSLs to align account-level engagement with broader commercial and scientific activities, in full compliance with channel and engagement rules.
• Provide structured payer intelligence and account insights back to Market Access leadership to inform pricing, contracting, and strategic positioning.
• Maintain accurate account plans, CRM activity, and reporting cadence; participate in business reviews and launch readiness forums.
• Perform other duties as may be assigned from time to time.

Job description

Capricor Therapeutics is seeking a National Account Director to own payer access and coverage strategy for national and regional payers, PBMs, and IDNs for Deramiocel. The role partners with Market Access, Medical Affairs, HEOR, Sales, and Patient Advocacy to translate the value proposition into coverage decisions for a high-cost, rare-disease cell therapy.

The position requires 10+ years in biotech/pharma market access with 5+ years in a senior payer-facing role, and established relationships