Director, US Value, Access, and Pricing Strategy

�

� Description

• • Own the end-to-end U.S. market access strategy for Orca-T, our first-in-class, high-precision cell therapy poised to launch in the near term. You will translate complex clinical and economic data into a compelling value story that secures payer coverage and provider reimbursement, ensuring every eligible blood-cancer patient can access a potentially life-saving transplant.
• • Serve as the single point of accountability for identifying, quantifying, and mitigating access risks across Medicare, Medicaid, commercial payers, and hospital systems. You will continuously scan the policy, competitive, and reimbursement landscape, turning early signals into decisive action plans that keep launch timelines and revenue forecasts on track.
• • Architect and execute innovative payer and provider value-creation tools—budget-impact models, outcomes-based contracts, J-code dossiers, site-of-care calculators, and patient-access roadmaps—working hand-in-hand with HEOR, Medical Affairs, Legal, and Finance to ensure scientific rigor and compliance.
• • Translate pivotal trial data and real-world evidence into a concise, evidence-rich value proposition that resonates with medical directors, pharmacy directors, and transplant-center administrators. You will co-create slide decks, AMCP dossiers, policy briefs, and objection-handling guides, then train and certify the national field team to deliver them flawlessly.
• • Partner with the Field Market Access Directors to design and deploy a tactical playbook that secures favorable coverage policies, prior-authorization criteria, and reimbursement rates at the national, regional, and site-of-care levels. You will track KPIs such as coverage rate, time-to-approval, and average selling price to refine tactics in real time.
• • Lead primary and secondary market research—payer advisory boards, ATU studies, claims analyses, and policy roundtables—to uncover unmet access needs, pricing elasticity, and evidence gaps. Insights will directly inform HEOR study design, publication strategy, and policy advocacy priorities.
• • Drive the U.S. pricing and contracting life-cycle strategy, including list price, ASP, WAC, and innovative value-based arrangements such as outcomes guarantees and risk-sharing agreements. You will model revenue scenarios, gross-to-net impacts, and government pricing implications to guide executive decisions.
• • Collaborate with Government Affairs to shape federal and state policies impacting CAR-T and allogeneic transplant reimbursement—CMS coverage, NTAP add-on payments, 340B eligibility, and site-of-care reimbursement. Your policy briefs and testimony will position Orca Bio as the thought leader in cell-therapy access.
• • Build and maintain a cross-functional launch-readiness dashboard that tracks policy changes, competitive launches, evidence updates, and payer feedback. You will present findings to the executive team and Board, ensuring transparent, data-driven decision-making.
• • Travel up to 20 % for payer negotiations, transplant-center engagements, policy summits, and internal off-site planning sessions, with a preference for proximity to Menlo Park to foster high-bandwidth collaboration with R&D, Clinical, and Executive leadership.