National Account Executive, Northeast (PA, NJ, Lower NY)

Genetix Biotherapeutics•Boston, MA

5d•$250,000 - $265,000•Remote

About The Position

Genetix Biotherapeutics is seeking a mission-driven National Account Executive to join their Market Access, Advocacy + Policy (MAAP) team. This field-based role will cover the lower Northeast region (PA, NJ, Lower NY) and requires approximately 50% travel. The primary responsibility is to implement strategic direction and execution of all payer engagements and access initiatives to ensure timely and sustained reimbursement for the company’s gene therapy portfolio. This involves engaging commercial and government payers, executing value-based agreements, and partnering with treatment centers to streamline access pathways. The ideal candidate will have deep expertise in payer strategy, contracting, treatment center collaboration, and leadership in specialty or gene therapy markets, with a passion for patient access to transformative treatments. The MAAP team is dedicated to helping patients access innovative gene therapies for debilitating diseases, working in a fast-paced, collaborative, and compliance-driven environment.

Requirements

10 years of experience in the biotech/pharma field with a bachelor’s degree required
A track record of success engaging tertiary and quaternary clinical and research institutions and integrated delivery networks on market access issues
Comprehensive understanding of the current and evolving US payer landscape within cell and gene therapies or complex therapies from a both medical and pharmacy benefit perspective
Strong clinical aptitude/acumen
Deep knowledge of U.S. markets and understanding of Commercial Payers, PBMs, Stop Loss and Reinsurance and Government Payers (FFS and Managed Medicaid, Medicare, and TRICARE)
Established relationships with Pharmacy Directors, Medical Directors, and other key stakeholders with assigned accounts
Demonstrated knowledge and specialty pharmacy and buy and bill procurement models across commercial and government payers; recent experience preferred
Demonstrated expertise as a subject matter expert (SME) for assigned key payer accounts with experience in navigating complex vertically integrated orgs
Travel 50%

Nice To Haves

Master’s degree in a relevant health or finance related field preferred
Demonstrated experience negotiating and implementing outcomes-based or other alternative payment models preferred

Responsibilities

Meet access goals and ensure medical coverage pathways are consistent with FDA approved prescribing information
Collaborate with Qualified Treatment Center (QTC) Account Liaisons, Marketing, Patient Support Team and Medical Value Liaisons and other Genetix stakeholders to identify access barriers and ensure patient access
Implement strategies and tactics to support individual patient access and reimbursement (e.g., coverage, coding) across payer segments
Serve as the primary, regional point-of-contact for Genetix’s Qualified Treatment Center network for all market access-related issues. Proactively educate QTC around state Medicaid and commercial payer coverage criteria, PA process and requirements as well as addressing account specific educational gaps in our treatment process and pathway. Create confidence in the access pathway for our therapies by leveraging published medical policies and patient approvals across the QTC network and aligning all messaging to our market access engagement strategy
Develop and maintain core relationships with the business functions at Genetix’s QTCs with a focus on patient pull through, including but not limited to, managed care contracting, CFO and revenue cycle, government affairs, billing department leads, along with hospital quality and legal teams, gene therapy coordinators, financial coordinators and PA and appeals support
Proactively work in a preventative measure with QTCs to establish hygienic PA submissions to alleviate incomplete submissions or administrative inaccuracies
Consistently engage National and Regional commercial payers, FFS and Managed Medicaid plans, and Federal payers to positively influence decision makers in areas of clinical criteria and medical policy. Present, negotiate and execute Value Based Agreements (VBA) at the payer level to facilitate timely access to FDA-approved Genetix therapies
Negotiate and manage value contracts with assigned payers for optimal Genetix product access
Respond to ad hoc requests by small regional payers in assigned territory
Work within the payer ecosystem to identify delays or friction in the approval process, develop a plan, and implement a timely resolution. Provide support and pull through strategies to the QTCs when to overcome delays within the process ex: PA requirements and any PA denials, distribution channel preference etc.
Educate QTCs with Letter of Intent on considerations for case rate agreements to reduce delays. Connect QTCs with other QTCs for best practice sharing or connect them with appropriate decision makers at the health plan for issue escalation and resolution.
Identify and leverage contacts within the payers and connect those payer stakeholders with the QTC to streamline PA review and approval processes
Work cross-functionally within the POD team structure to ensure alignment across Genetix’s stakeholders and that QTCs receive surround sound support at every step in the patient journey; these cross functional partners include: apheresis, patient support, field medical, legal and contracting, and working closely with the QTC account leads to mitigate and/or remove barriers to care at the consult and treatment phases of the patient journey.
Work closely with Medical Value Liaison (MVL) in tandem for targeted situations e.g. PA prep, appeals, policy and coverage influence
Share insights and feedback from across market access stakeholders (with a focus on payers and financial decision makers at QTCs)
Encourage and facilitate QTC patient’s enrollment into Genetix’s patient support program My Bluebird Support (MBS) to enrich the patient treatment journey
Maintain the utmost standard of professionalism and compliance in all internal and external engagements