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PANTHERx Rare

Senior Strategic Account Manager, Government Programs

Posted 6 Days Ago
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Remote
Hiring Remotely in United States
Senior level
Remote
Hiring Remotely in United States
Senior level
Leads government payer strategy across Medicaid, Medicare, TRICARE, and other public programs. Manages payer relationships, engagement plans, reimbursement and access initiatives, regulatory monitoring, stakeholder meetings, contract support, and issue resolution. Collaborates with Legal, Compliance, Finance, Operations, Clinical, and executive teams while serving as the subject matter expert on government healthcare programs. Represents the organization at industry and public payer forums.
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7,000 Diseases - 500 Treatments - 1 Rare Pharmacy

PANTHERx is the nation’s largest rare disease pharmacy, and we put the patient experience at the top of everything that we do.

If you are looking for a career in the healthcare field that embraces authentic dedication to patient care, you don’t need to look beyond PANTHERx. In every line of service, in every position and area of expertise, PANTHERx associates are driven to provide the highest quality outcomes for our patients.

We are seeking team members who:

Are inspired and compassionate problem solvers;

Produce high quality work;

Thrive in the excitement of the ever-challenging environment of modern medicine; and

Are committed to achieving superior health outcomes for people living with rare and devastating diseases.

At PANTHERx, we know our employees are the driving force in what we do. We cultivate talent and encourage growth within PANTHERx so that our associates can continue to explore their interests and expand their careers. Guided by our mission to provide uncompromising quality every day, we continue our strategic growth to further reach those affected by rare diseases.

Join the PANTHERx team, and define your own RxARE future in healthcare!

Senior Strategic Account Manager, Government Programs

Location: Pittsburgh, PA (Remote)

Classification: Exempt

Status: Full-time

Reports to: Director, Payer Relations

Purpose

The Senior Strategic Account Manager, Government Programs serves as the primary owner of PANTHERx Rare Pharmacy government program strategy, with focus on Medicaid, Medicare, TRICARE, and other public sector programs as needed. This role is responsible for developing and executing state and federal payer engagement strategies, building and maintaining high-value relationships with government stakeholders, monitoring legislative and regulatory activity, and driving fair reimbursement, access, compliance, and patient care objectives.

In addition to leading government payer strategy, this role directly manages day-to-day engagement with assigned state Medicaid programs and other government payers, including routine communication, issue tracking, QBR coordination, stakeholder meeting preparation, reimbursement barrier escalation, and documentation of follow-up actions.

Responsibilities

  • Leads the development and execution of government payer strategies across Medicaid, Medicare, TRICARE, and other public sector programs to support fair reimbursement, patient access, and organizational growth.
  • Serves as the primary relationship owner for assigned government payer accounts, building and maintaining strategic relationships with key decision-makers, policymakers, agencies, and other stakeholders at the state and federal level.
  • Develops and executes payer engagement plans that strengthen PANTHERx's position within government programs, communicate the clinical value of rare disease therapies, and support reimbursement, access, and policy objectives.
  • Monitors and influences the government payer landscape by tracking legislative and regulatory changes, reimbursement trends, DUR boards, P&T committees, and other relevant stakeholder activities, providing actionable insights to leadership.
  • Leads government payer meetings and business reviews, including strategic planning, stakeholder engagement, meeting preparation, performance reporting, issue tracking, and follow-up activities.
  • Identifies, prioritizes, and drives resolution of reimbursement, access, policy, and operational challenges impacting government payer relationships through effective partnership with internal and external stakeholders.
  • Collaborates cross-functionally with Legal, Compliance, Finance, Operations, Clinical, and executive leadership to ensure alignment on payer strategy, regulatory requirements, contract initiatives, and issue resolution.
  • Serves as the organization's subject matter expert on government programs, providing leadership with recommendations on market dynamics, risks, opportunities, reimbursement strategies, and policy developments.
  • Supports contract negotiations, policy positioning, and value proposition development to advance organizational objectives within government healthcare programs.
  • Represents PANTHERx at industry conferences, stakeholder meetings, and public payer forums to advocate for patient access and organizational priorities.
  • Performs other related duties as assigned.

Required Qualifications

  • Bachelor's degree in business, healthcare, public policy, or related field.
  • Minimum of ten (10) years of experience in government programs, managed care, PBM, specialty pharmacy, or healthcare strategy.
  • Deep knowledge of Medicaid, Medicare, TRICARE, reimbursement methodologies, and state and federal healthcare policy.
  • Proven ability to build and influence relationships with government stakeholders, policymakers, and payer decision-makers.
  • Demonstrated success leading complex initiatives and collaborating across multiple business functions.
  • Strong strategic thinking, analytical, problem-solving, and issue-resolution capabilities.
  • Excellent communication, presentation, and stakeholder management skills.
  • Highly organized, accountable, and driven by a commitment to patient access and care, with willingness to travel as needed (up to 40%).

Preferred Qualifications

  • Master’s degree in business, healthcare, public policy, or related field.
  • Experience leading Medicaid payer engagement, state-level reimbursement strategy, or public payer QBRs within specialty pharmacy or rare disease settings.

Work Environment

This position works in a home or professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

While performing the duties of this job, the employee is regularly required to sit, see, talk, or hear. The employee frequently is required to stand; walk; use hands and fingers to handle or feel; and reach with hands and arms. Visual acuity is necessary for tasks such as reading or working with various forms of data for extended periods of time. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.

Benefits:

Hybrid, remote and flexible on-site work schedules are available, based on the position. PANTHERx Rare Pharmacy also affords an excellent benefit package, including but not limited to medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program! Generous paid time off is also available to all full-time employees. Of course we offer paid holidays too!

Equal Opportunity:

PANTHERx Rare Pharmacy is an equal opportunity employer, and does not discriminate in recruiting, hiring, promotions or any term or condition of employment based on race, age, religion, gender, ethnicity, sexual orientation, gender identity, disability, protected veteran's status, or any other characteristic protected by federal, state or local laws.

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