Vice President, National Payer Accounts

Scorpion Therapeutics; Watertown (MA); On-site; USD 260,000 - 380,000; Full time

Job summary

Scorpion Therapeutics seeks a visionary VP level leader to own national payer accounts for our retina portfolio, spanning commercial, Medicare Part B, and Medicaid. This role drives coverage policy, contracting, and value-based negotiations while building a high-impact national accounts team.

You will navigate Part B reimbursement mechanics, establish payer relationships, and collaborate across Trade, HUB, and Medical Affairs to ensure successful launch and sustained access post-launch.

Qualifications

• 15+ years in pharma/biotech market access or payer strategy; 3+ years in VP/senior leadership.
• Experience launching Medicare Part B buy-and-bill products and navigating J-codes.
• Retina or ophthalmology experience strongly preferred.
• Proven ability to build payer strategy pre-launch and drive growth post-launch.
• Expert knowledge of Part B reimbursement mechanics (ASP, buy-and-bill, site-of-care).
• Working knowledge of IRA provisions and pricing impact on access.
• Proven senior-level negotiation track record with national payers/PBMs.
• Experience building and leading national accounts teams; player-coach mindset.
• Bachelor's degree required; MBA/healthcare degree a plus.

Responsibilities

• Own national payer account strategy across commercial, Medicare, and Medicaid for retina products.
• Serve as senior relationship owner for top payers and PBMs; lead coverage policy contracting.
• Build and lead the national accounts team; manage government pricing and contract operations.
• Lead payer-facing launch readiness and J-code transition activities.
• Collaborate with Trade/Distribution, HUB, and Medical Affairs for launch coordination.
• Represent payer strategy to C-suite, executives, and Board as needed.
• Monitor Part B policy landscape and advise on pricing/contracting impacts.

Skills

Payer strategy

Payer negotiations

Market access leadership

National accounts

Pre-launch strategy

Part B reimbursement

J-code navigation

Team leadership

Pricing policy awareness

Education

Bachelor's degree

MBA/Healthcare degree

Job description

Vice President, Head of National Payer Accounts

Key Accountabilities

• Own national payer account strategy across commercial, Medicare (incl. MACs), and Medicaid for a buy-and-bill Part B retina product
• Senior relationship owner for top national/regional payers and PBMs; lead direct negotiations on coverage policy, contracting, and value-based arrangements
• Build and lead the national accounts team and trade/distribution role as the business scales post-launch ("player-coach" in year one)
• Own government pricing and contract operations for the retina portfolio (ASP reporting, 340B, contract compliance) with Finance/Legal; partner as Trade/Distribution executes chargebacks and contract price administration

Launch Execution

• Lead payer-facing launch readiness: coverage policy, prior authorization criteria, and claims/billing pathways through the J-code transition
• Partner with Trade & Distribution, Reimbursement/HUB, and Medical Affairs for coordinated provider/payer launch
• Collaborate with patient support/HUB and co-pay assistance; ensure SD/SP capacity and product availability for buy-and-bill onboarding
• Develop and defend the payer value story (clinical, economic, HEOR)

Cross-Functional & Executive Engagement

• Represent payer strategy/account status to CCO, executives, and Board as needed
• Partner with Sales leadership to align field access/reimbursement support with national account strategy
• Provide input to pricing, contracting, and gross-to-net strategy based on payer intelligence

Market & Policy Monitoring & Engagement

• Track evolving Part B policy landscape; translate into account strategy/forecasting
• Maintain fluency in IRA provisions relevant to Part B/Part D and downstream pricing/access impacts
• Engage in health policy activities (e.g., CMS comment letters)
• Monitor competitive payer coverage and contracting across retina category

Qualifications

Required

• 15+ years in pharma/biotech market access, national accounts, or payer strategy; 3+ years at VP/senior leadership with direct payer negotiation ownership
• Experience launching Medicare Part B buy-and-bill product; navigate miscellaneous J-code to permanent coding
• Retina or broader ophthalmology experience strongly preferred
• Demonstrated success building payer strategy pre-launch and leading through launch/post-launch growth (ideally from scratch in a small/mid-cap biotech)
• Expert knowledge of Part B reimbursement mechanics (ASP methodology, buy-and-bill economics, site-of-care, specialty pharmacy/distribution)
• Working knowledge of IRA provisions and impact on pricing/access/contracting
• Proven senior-level negotiation track record with national payers/PBMs
• Experience building/leads national accounts team; comfortable as "player-coach" during build-out
• Bachelor's degree required; MBA/healthcare-related degree a plus

Preferred

• Small/mid-cap biotech experience during first-in-class/category launch
• Existing relationships across major national payers and specialty distributors for retina/buy-and-bill
• Familiarity with evolving MFN/Part B pricing policy landscape