Director, Specialty Pharmacy and Payer Accounts

Director, Specialty Pharmacy and Payer Accounts

Background:

Specialty Pharmacy and Payer Accounts span multiple distinct commercial segments - each with its own stakeholders, economics, and pull-through levers, yet all interconnected within a single vertically integrated organization. The GSK account team is structured to ensure each segment receives dedicated commercial expertise, while operating as a coordinated unit across the full stack. This role owns payer segments and Specialty Pharmacy which serves members through its specialty dispensing network. These segments are strategically linked: formulary decisions made at the health plan level shape Specialty Pharmacy (SP) channel routing, and SP dispensing performance directly reflects the commercial value of payer access wins.

Role Description:

This is a Market Access enterprise account director within the Specialty Pharmacy and Payer enterprise account team, accountable for commercial performance across interconnected segments. This role must coordinate closely with them to ensure that payer access gains are translated into SP pull-through execution, and that SP performance data informs payer engagement strategy.

The Director will be responsible for: 1) Managing health plan commercial relationships - engaging pharmacy and medical leadership on formulary access, utilization management policy, and coverage design across the portfolio. 2) Driving specialty pharmacy pull-through performance- owning account relationships, performance scorecards, and patient access execution across both SP partners. 3) Coordinating with PBM and GPO segment owners within the enterprise team to ensure integrated account strategy and aligned messaging across the Specialty Pharmacy and Payer stack. 4) Providing the enterprise team and leadership with segment-level performance intelligence and access barrier analysis.

Specific responsibilities include:

• Own the commercial health plan account relationship - engaging pharmacy directors, medical directors, and clinical policy leadership on formulary tier positioning, prior authorization criteria, step therapy design, and coverage policy across the portfolio.

• Monitor and respond to health plan coverage decisions - tracking formulary updates, utilization management changes, and clinical policy shifts that affect portfolio access, and coordinating rapid responses with the enterprise team and leadership.

• Drive SP pull-through performance- managing the commercial account relationship, executing against performance scorecards covering time-to-fill, dispense rates, hub handoff quality, patient persistence, and REMS compliance.

• Translate payer access outcomes at the health plan into SP pull-through priorities- ensuring that formulary wins are activated at the dispensing level and that SP performance gaps are connected back to upstream payer access barriers.

• Coordinate with the Enterprise Team on enterprise messaging alignment.

• Lead regular business reviews with stakeholders - presenting portfolio performance data, reporting on joint commitments, and aligning on pull-through initiatives.

• Build and maintain segment-level performance dashboards - tracking formulary access status, SP dispense performance, co-pay utilization, and patient access metrics across all three segments.

• Identify and escalate access failures - prior authorization denials, step therapy barriers, SP dispensing gaps - to the enterprise team lead and leadership with root cause analysis and recommended responses.

Candidate Description & Qualifications

The successful candidate will have a proven record of payer access account management and specialty pharmacy pull-through execution, with the commercial fluency to navigate both the health plan and SP sides of a vertically integrated account and coordinate effectively within a structured enterprise team.

Basic Qualifications:

• Bachelor's degree required.

• 10+ years of pharmaceutical commercial experience.

• 4+ years in payer access managed care account management, or specialty pharmacy channel management roles.

• Experience managing a health plan or managed care account - engaging pharmacy directors, medical directors, or clinical policy teams on formulary access and utilization management.

• Experience managing specialty pharmacy account relationships and driving SP pull-through performance against measurable scorecards.

Preferred Qualifications:

• MBA or advanced degree in Business, Health Economics, or Healthcare Administration.

• Prior Director-level managed care or specialty pharmacy account experience at a top-tier pharmaceutical or large biotech company.

• Ability to connect payer access strategy with SP pull-through execution - understanding how formulary decisions upstream shape dispensing outcomes downstream.

• Track record of working effectively within a cross-functional or team-based enterprise account structure.

• Strong analytical skills - ability to build and present segment-level performance analyses to senior internal and external stakeholders.

• Oncology or specialty therapeutic area experience preferred, including familiarity with REMS programs, LDD products, and specialty benefit channel mechanics.

Location: Field Based (National)