Director of Payer Strategy

Thea Pharma•Waltham, MA

5d•Remote

About The Position

The Director of Payer Strategy will possess deep expertise and a successful track record in developing, implementing, and optimizing market access strategies that ensure broad and sustainable payer coverage across commercial and government healthcare markets. This individual will serve as the strategic business owner for payer access while overseeing external payer account management vendors responsible for executing payer engagement activities. The role requires strong collaboration across the U.S. Commercial organization to define market access strategies, establish account priorities, oversee execution, and continuously monitor performance to optimize formulary access, reimbursement, and patient affordability. This leader will translate corporate objectives into actionable payer strategies while ensuring external partners effectively execute against established goals and performance expectations. This position will partner closely with Commercial Leadership, Hub Services, Provider Access & Reimbursement, Sales, Marketing, Medical Affairs, Regulatory, Legal, Compliance, Finance, Commercial Operations, Analytics, Distribution, and external payer account management organizations to ensure successful commercialization and market access across Théa’s product portfolio. This role reports to the Head of Market Access.

Requirements

Deep understanding of commercial and government payer markets, managed care, reimbursement, formulary management, healthcare policy, and pharmaceutical market access.
Demonstrated experience developing payer strategies and managing payer account organizations or third-party market access vendors.
Strong understanding of pharmaceutical product launches, payer evidence requirements, contracting principles, and reimbursement strategy.
Experience developing strategic account plans, KPIs, executive dashboards, vendor scorecards, and business performance reporting.
Strong analytical skills with the ability to interpret claims data, payer analytics, competitive intelligence, and market trends to support strategic decision-making.
Proven ability to influence and lead cross-functional initiatives involving Commercial, Medical Affairs, Marketing, Sales, Finance, Patient Services, and Provider Access organizations.
Excellent executive communication and presentation skills with demonstrated ability to influence senior leadership and external partners.
Strong vendor management, negotiation, and relationship management skills with the ability to hold external partners accountable for execution and results.
Demonstrated ability to thrive in a fast-paced commercial environment supporting multiple product launches and evolving market access strategies.
Strong understanding of pharmaceutical regulatory requirements, healthcare compliance, and appropriate interactions with healthcare decision-makers.
Extensive proficiency with Microsoft Office (Word, Excel, PowerPoint, Teams, Outlook) and market access analytics platforms.
Bachelor’s degree required
12+ years of progressive pharmaceutical, biotechnology, or specialty healthcare experience with significant responsibility in market access, managed markets, payer strategy, national accounts, or reimbursement.
5+ years of leadership experience managing payer account teams, managed markets organizations, or third-party market access vendors.
Product launch experience required, including development and execution of payer access strategies.

Nice To Haves

MBA, PharmD, MPH, or other advanced degree preferred.
Experience supporting buy-and-bill and specialty pharmaceutical products strongly preferred.
Experience in ophthalmology or specialty pharmaceuticals preferred.

Responsibilities

Lead the development, execution, and continuous optimization of Théa’s payer strategy across commercial and government healthcare markets.
Serve as the primary business owner for third-party payer account management vendors responsible for national and regional payer engagement.
Develop strategic payer engagement plans, account prioritization, value propositions, evidence strategies, and market access objectives aligned with commercial goals.
Establish vendor governance programs including routine business reviews, performance scorecards, strategic planning sessions, and operational oversight.
Develop and monitor Key Performance Indicators (KPIs), Management by Objectives (MBOs), account performance metrics, formulary access measures, pull-through effectiveness, and executive dashboards to evaluate vendor performance and overall market access success.
Partner with external payer account teams to establish annual account plans, engagement strategies, negotiation priorities, and tactical execution plans while maintaining accountability for performance outcomes.
Monitor payer coverage decisions, utilization management policies, prior authorization requirements, reimbursement trends, competitive dynamics, and market access barriers while proactively recommending strategic actions.
Collaborate with Medical Affairs, HEOR, Marketing, and Commercial Operations to develop payer value propositions, clinical messaging, economic evidence, and customer-facing resources supporting payer engagement.
Partner with Patient Support Services and Provider Access & Reimbursement to ensure payer strategies are effectively operationalized through patient support programs, reimbursement resources, and provider education.
Work collaboratively with Sales Leadership and Commercial Operations to develop field communication strategies, pull-through initiatives, and customer education supporting market access objectives.
Identify evolving healthcare policy, reimbursement, legislative, and regulatory trends that may impact market access while communicating implications and recommendations to Commercial Leadership.
Lead market access planning and execution for product launches, including payer strategy development, vendor readiness, account targeting, access analytics, and launch performance monitoring.
Develop and manage departmental budgets, vendor contracts, consulting relationships, and strategic initiatives supporting market access objectives.
Utilize internal and external market intelligence, claims data, payer analytics, competitive intelligence, and business performance metrics to inform strategic decisions and continuously improve access performance.
Ensure all payer engagement activities comply with applicable healthcare regulations, company policies, and compliance standards.