Payer Account Director / Government Accounts (PAD-GA)

Job Description

Position Overview:

The Payer Account Director–Government Accounts (PAD-GA) leads national payer and PBM strategies to secure optimal access and reimbursement for Vertex’s commercialized products in Federal and State Medicaid channels. This includes ensuring appropriate pharmacy and medical benefit policies, building relationships with key decision-makers, negotiating contracts, and aligning Vertex’s value with payer priorities.

As the primary contact for assigned national accounts, the PAD-GA drives market access, supports sales across Business Units, and ensures strategic alignment to improve patient access and brand performance. The role involves collaborating with Payer Account Associate Directors (PAADs) and Payer Account Directors (PADs) to develop and execute plans to achieve shared Medicaid access goals and enhance regional pull-through. The PAD-GA also creates and manages comprehensive “mega account” business plans.

This national role includes direct responsibility for accounts such as the VA, DoD, Medicaid state PBA pooling groups (Prime/Magellan and Optum/ChangeHealthcare), and the Indian Health Service.

Key Responsibilities

• Strategic Planning and Execution:
  • Develop and implement strategic account plans for assigned payers and PBMs
  • Create and execute comprehensive “mega account plans” for all assigned accounts
  • Collaborate with internal teams to align strategies and achieve access goals
• Relationship Management:
  • Build and maintain trusted relationships with key payer decision-makers, including C-suite stakeholders, Medical Directors, and Pharmacy/Industry Relations leaders
  • Serve as the primary point of contact for assigned accounts, ensuring timely issue resolution and proactive communication
• Contract Negotiation and Management:
  • Lead contract negotiations with assigned accounts to secure favorable formulary positioning and access
  • Develop business cases, conduct financial analyses, and negotiate contractual terms to maintain profitable access to Vertex products
• Market Analysis and Insights:
  • Maintain deep knowledge of Federal healthcare systems, reimbursement models, and payer operations
  • Analyze competitive dynamics and market trends to inform internal stakeholders and adjust strategies
  • Leverage data and insights to support value-based discussions and demonstrate product differentiation
• Education and Advocacy:
  • Educate accounts on disease states, unmet needs, and reimbursement pathways using approved resources
  • Collaborate with internal teams to ensure effective pull-through execution and education
• Compliance and Integrity:
  • Ensure all activities and communications comply with company policies and ethical standards

Key Accounts

• Medicaid state PBA pooling groups (Prime/Magellan and Optum/ChangeHealthcare)
• Veterans Affairs (VA)
• Department of Defense (DoD)
• Indian Health Service

Qualifications

• Education: Bachelor’s degree in a relevant discipline
• Experience:
  • 10+ years in the pharmaceutical/biotech industry, with 5+ years in field market access (preferably in government channels)
  • Recent experience in direct contracting with large national payers; outcomes-based agreement experience preferred
  • Expertise in both pharmacy and medical in-patient reimbursement products
  • Strong understanding of U.S. government payer landscape and managed care
• Skills:
  • Strategic, analytical, and collaborative thinking
  • Excellent oral and written communication skills
  • Proven ability to build and maintain strong customer relationships
  • Results-oriented with a track record of success
• Other Requirements:
  • Ability to thrive in a fast-paced, innovative environment
  • Willingness to travel extensively
  • Valid driver’s license

This role is critical in ensuring that Vertex’s products achieve broad and equitable access, driving both patient outcomes and business success.

Pay Range:

$200,000 - $300,000

Disclosure Statement:

The range provided is based on what we believe is a reasonable estimate for the base salary pay range for this job at the time of posting. This role is eligible for an annual bonus and annual equity awards. Some roles may also be eligible for overtime pay, in accordance with federal and state requirements. Actual base salary pay will be based on a number of factors, including skills, competencies, experience, and other job-related factors permitted by law.

At Vertex, our To