Overview
Lumicera Health Services is seeking a Sr. Director, Industry and Payor Strategy to join our team!
The Sr. Director, Industry and Payor Strategy provides strategic leadership for Lumicera's industry partnerships, payor strategy, and specialty pharmacy market access. This leader establishes and executes a multiyear strategy that expands access to medications and payor networks, strengthens competitive positioning, and delivers sustainable growth and financial performance. The role leads a team of experienced professionals and develops executive-level relationships with pharmaceutical manufacturers, health plans, pharmacy benefit managers (PBMs), wholesalers, group purchasing organizations (GPOs), health systems, and other strategic partners. Accountability includes limited distribution drug (LDD) access, manufacturer and enhanced service agreements, payor network participation and reimbursement strategy, procurement and GPO contracting, and health system partnerships.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Serve as a strategic advisor to the Chief Growth Officer and senior leadership, translating industry and payor insights into recommendations on market positioning, partnership priorities, investment decisions, and enterprise growth opportunities.
Lead and develop a high-performing industry and payor strategy team; establish clear decision rights, priorities, and accountability for strategic execution, partner outcomes, and financial results.
Build organizational capability through leadership development, succession planning, coaching, and continuous improvement; align team structure and capabilities with evolving industry and payor priorities.
Own the development and execution of the multiyear industry and payor strategic plan, including annual operating priorities, resource allocation, departmental budgets, and measurable growth, access, and profitability objectives aligned with Lumicera's enterprise strategy.
Provide leadership and management to ensure that the mission and core values of Lumicera are put into practice and shared with strategic partners.
Lead executive and cross-functional alignment on strategic priorities, communicating business cases, tradeoffs, risks, and progress to secure sponsorship and drive coordinated execution across commercial, clinical, operations, finance, legal, and compliance teams.
Define and lead payor strategy across health plans, PBMs, and other purchasers, prioritizing network access, preferred specialty pharmacy positioning, reimbursement sustainability, and strategic partnerships that support patient access and profitable growth.
Direct complex negotiations with manufacturers, payors, PBMs, wholesalers, GPOs, and health systems for distribution, procurement, network participation, reimbursement, and service agreements. Establish negotiation objectives and financial guardrails, obtain required approvals, and oversee implementation, contractual compliance, and realization of agreed-upon economics.
Develop and steward executive-level relationships with pharmaceutical manufacturers, payors, PBMs, wholesalers, GPOs, health systems, and providers; establish joint strategic plans that expand access, reduce costs, diversify revenue, and strengthen long-term partnership value.
Lead cross-functional development of differentiated payor and industry value propositions, including clinical outcomes, patient experience, total cost of care, and service capabilities; translate these into partnership proposals, requests for proposal responses, and scalable commercial offerings.
Establish portfolio-level contracting strategy and governance, including pricing and reimbursement frameworks, renewal priorities, performance guarantees, analytical controls, and audit processes. Evaluate contract profitability, concentration risk, and strategic fit, and recommend corrective actions or alternative arrangements.
Own the manufacturer access and specialty product portfolio strategy, prioritizing LDD opportunities, enhanced service programs, and emerging therapies. Direct launch readiness and agreement implementation to align product access with payor coverage, operational capabilities, and patient needs.
Other duties as assigned.
Qualifications
What our team expects from you?
Bachelor's degree in Business, Healthcare, Health Services, Pharmacy, or a related field, or equivalent work experience, required. MBA, MHA, or PharmD from an accredited pharmacy school preferred.
10+ years of progressive experience in specialty pharmacy, pharmaceutical industry relations, market access, payor or PBM strategy, trade relations, account management, or a related industry, required.
5+ years of progressive leadership experience, including strategic oversight and experience leading individual contributors and/or other leaders, required.
Experience in contract negotiation required, with strong preference in specialty or PBM rebate contracting.
Knowledge of specialty pharmacy medications, including REMS requirements and Limited Distribution Drug (LDD) best practices, required.
Participate in, adhere to, and support compliance program objectives.
The ability to consistently interact cooperatively and respectfully with other employees.
What can you expect from Lumicera?
Top of the industry benefits for Health, Dental, and Vision insurance
20 days paid time off
4 weeks paid parental leave
9 paid holidays
401K company match of up to 5% - No vesting requirement
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance
Referral Bonus Program -- up to $750!
LI-Remote
Navitus Health Solutions is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by law.
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