National Account Director - Payer Access presso Ocular Therapeutix

Position Summary:

The National Account Director will be field-based strategic leader responsible for driving appropriate access and coverage for Ocular’s portfolio across key commercial self-insured employers and Medicare Part D payers.  The National Account will develop and maintain relationships with national and regional Medicare payers, third party administrators, Pharmacy Benefits Managers (PBM), employers and employee employer coalitions to ensure coverage and reimbursement.  The ideal candidate will have a successful track record of payer engagement and strategic account management in the commercial self-insured and/or Medicare Part D channels.

The National Payer Accounts Director will secure unencumbered access for current and pipeline biologics, focusing on ophthalmology and retina, with emphasis on protecting and growing Dextenza  and advancing Phase 3 candidate products through Payer Initiated Engagements (PIE). This role requires building deep payer relationships, leading pre-launch/launch strategies, and collaborating cross functionally to ensure optimal reimbursement across all payer types.

Principal Duties and Responsibilities include the following:

• Payer Engagement: Call on all payer books (Commercial, Medicare FFS, Medicare Advantage, Medicaid, 340B, MACs) to secure formulary access and favorable reimbursement for Dextenza and pipeline biologics. A plus: experience with Government/DoD/VA accounts.
• Access Strategy: Develop and execute strategies to protect/grow Dextenza and achieve unencumbered access for future product candidates, addressing coverage barriers and negotiating contracts.
• Pre-Launch/Launch: Lead PIE for Phase 3 candidates and execute pre-launch/launch plans for retina-focused biologics, aligning clinical and HEOR data with payer needs.
• Relationship Building: Cultivate deep, strategic relationships with payer decision-makers (medical/pharmacy directors, executives) to drive long-term partnerships.
• Cross-Functional Collaboration: Partner with medical affairs, sales, marketing, HEOR, and regulatory teams to align strategies and integrate payer insights.
• Performance Monitoring: Track access metrics, reimbursement trends, and competitive landscape; report to senior leadership.
• Compliance: Adhere to industry regulations and ethical standards in all payer interactions.
• Eliminate and/or significantly reduce barriers to access and reimbursement for both drug (J- and C- Codes) and procedural coding (CPT) across Medicare FFS, Medicare Advantage and Commercial payer segments
• Develop strategic plans to target, engage and build relationships with key personnel within assigned Medicare FFS (MACs), Medicare Advantage, and Commercial
• Engage targeted (Medicare FFS, Medicare Advantage, and Commercial) Payer Technology Assessment Committees, Medical Directors, Medical Policy Departments, and Pharmacy Departments to deliver the DEXTENZA value proposition and obtain favorable coverage/separate payment for DEXTENZA via a compelling clinical and compliance value propositions.
• Formulate a clear and compelling disease and product value proposition through the creation of payer engagement tools.
• Provide education as needed and be the internal “go-to” resource for payer related questions from the field and corporate headquarters.
• Continuously maintains a compliant environment

Qualification Requirements:

• Education: Bachelor’s degree (Business, Healthcare, Life Sciences); MBA, PharmD, or MPH preferred.
• Experience: 10+ years in biotech/pharma market access, 5+ in payer-facing roles, with expertise in ophthalmology/retina biologics and Dextenza. Proven success in launch/pre-launch and payer negotiations.
• Skills:
• Self-motivated with strategic mindset and independent work ethic.
• Exceptional relationship-building and communication skills.
• Strong analytical skills for payer data and market trends.
• Proficient in cross-functional collaboration and matrix team leadership.
• Other: Up to 50% travel. Deep knowledge of U.S. reimbursement systems (Medicare Part B/D, commercial, value-based care).