Director – Payer Contract Analytics

Job Description

The Market Access & Patient Services (MAPS) organization within APEX plays an instrumental role in shaping payer market access and patient services strategies for all of AbbVie’s domestic brands. As a people leader of the Payer Contract Analytics team, you will greatly influence securing market access across all therapeutic areas and payer channels by executing contracting strategies and leading all deal model analytics. You will partner with Business Evolution Strategy Development (BESD) functions to build and scale deal analytics that reflect emerging market access and distribution models. You will play a key role in modernizing the overall Payer Contract Analytics (PCA) function through process and analytical methodology improvements and AI-guided initiatives.

In this role, you will closely collaborate with internal stakeholders from Finance, Forecasting, BTS, Legal, Payer Strategy, Pricing as well as field-based Account Managers to establish approved contracting terms that maximize brand net sales. With a focus on all traditional payer channels as well as emerging disruptive channels, you will ensure that pricing and contracting strategies are executed through sophisticated Bayesian and other advanced simulation techniques.

You will also lead a team of contract analytics talent, embed analytical capabilities to extend team member capabilities, enable organizational learning to ensure the development of access strategies that align with overall commercial goals of each brand. The role requires strong real-world data modeling skills and subject matter expertise within the overall U.S. market access environment and an in-depth understanding of the continuously evolving payer reimbursement landscape.

This position requires strong leadership and influencing skills required to obtain optimal access for AbbVie’s medicines at key National PBM’s and Payers such as Caremark, Express Scripts, and Optum. Together, ~80% of US Net Sales each year are the result of formulary placements and restrictions across these 3 customers.

Strategic Contributions

Lead payer contract analytics across Market Access for AbbVie Immunology brands.  Influence the implementation of brand-level pricing and contracting strategies at the customer level to achieve optimal payer formulary access that maximize net sales for assigned brands. Demonstrate very strong understanding of the U.S. payer landscape to translate and apply brand access strategies to the unique characteristics of our customers. Identify through advanced modeling, the risks, opportunities, and sensitivities associated with various access projection outcomes. Play a significant role in serving as an independent voice for Executive leadership decision making through strong story telling skills and payer contract strategy acumen. Build collaborative relationships with internal U.S. Market Access Sales, vendor partners, and Marketing stakeholders.

• Leading the process for executing Pricing and Contracting strategies at the Big 3 PBMs that maximize Gross-to-Net (GTN) budgets.
• Serve as an authority in the customization of channel-specific contracting strategies based on the unique asks and attributes of our customers to find financially prudent paths forward during negotiations.
• Modeling payer response to potential contract terms, measurement of brand dynamics for various formulary placement and utilization management tactics, and tracking post-deal account level performance through ROI/variance analyses using customer and secondary data sources.
• Influencing senior account executives and payer marketers through strategic problem solving and innovative scenario planning in seeking win-win solutions through negotiations.
• Interfacing with external customers such as PBMs and Health Plans to share analytical insights and positively influence deal negotiations.
• Shaping pricing and contract decision making with high fidelity, data-driven deal recommendations at the BU President, CCO and CFO level seeking deal approval.
• Demonstrating a strong understanding of syndicated and AbbVie proprietary data, data science and modeling techniques and the ability to synthesize insights into compelling therapeutic area value narratives.
• Continuously evolving contracting models to reflect the intricacies of complex customer business models, such as 340B concessions, enabling AbbVie to understand stakeholder economics from a patient and payer perspective and maximize AbbVie’s leverage with customers.
• Lead pre- and post-deal analytics and provide recommendations for access that seek to advance the objectives of the Brand/Therapeutic Area (TA), while optimizing the Brand’s Gross-to-Net (GTN).
• Perform GTN reconciliation of the deal financials compared with the Brand’s applicable forecast (LBE, Plan, LRP) to identify and quantify the variances in price, volume, and utilization mix for Financial planning.

Leadership Responsibilities

• Coordinate and facilitate Market Access cross-functional teams (Accounts, Marketing) to rationalize reasonable & realistic bid response strategies, shape specific scenarios and assumptions, illustrate payer performance through fact-based analysis, perform and present deep financial analysis that lead to optimal proposals to our customers.
• This people leadership role involves managing and mentoring direct reports to ensure timely and accurate responses to Payer contract bids/RFPs, simplifying the portrayal of complicated financial deals to better encompass the “all-in” investments, 360-degree stakeholder economics, and pros/cons of the negotiation strategy.
• Foster a collaborative and inclusive team environment encouraging new insight generation and continuous improvement.

Operational Assignments

• Develop and/or refine the analysis for allocating copay and voucher spend by product and by payer, which provides an enhanced GTN picture of the “all-in” cost of a proposed deal, influencing AbbVie internal stakeholders to make better informed financial decisions when approving deals.  Also, lead the communication and education process of how the analysis is done for Payer Marketing and Patient Services and collaborate with these teams to incorporate the findings into financial planning.
• On an annual basis, drive and support the development of Medicare Part D and Commercial channel key insights for 3-5 products.
• On a quarterly basis, lead direct reports on the creation and the updating of contract performance reporting to inform AbbVie internal stakeholders on underperforming contracts so early corrective actions can be deployed.
• Spearhead the identification of Commercial and Medicare payer rebate data that will provide new contract insights to pave the way for opportunities to improve contracting strategies.  Collaborate with Pricing to secure the data field submissions from the payers and with BTS to add those data fields to existing rebate tracking tools.
• Develop new and continually refine existing contracting models to capture the constantly evolving payer business model and product lifecycles.

Qualifications

• Strong business and financial acumen – prior experience in Contracting with an emphasis on actuarial modeling, scenario planning, and/or financial analysis are core competencies sought for this position.  
• Requires the ability to work in a matrixed environment while demonstrating and aligning to AbbVie’s cross-functional ways of working.
• Strong knowledge of channel dynamics/healthcare policy changes and possesses the ability to translate this understanding into actionable strategies using advanced analytics methods.
• Working knowledge of enterprise BI visualization tools to extract/analyze data and communicate a value story through insights.
• Experience managing and analyzing patient claims data (e.g. IQVIA LAAD, Symphony Health data, MMIT formulary status data) for Pharmacy channel products.
• Robust understanding of pharmacy channel stakeholder economics, including Payers, Pharmacy benefit managers (PBMs), and Group Purchasing Organizations (GPOs).
• Ability to develop insights and communicate complex information synthesized into concise and impactful talking points to effectively influence executive level decisions.  
• Experience influencing contract strategy decisions through rigorous data-driven drug pricing and utilization studies.

Work experience and Educational Requirements:

• 10+ years of work experience in management consulting, data/financial analysis type of roles, 5+ years of Market Access Payer Analytics, evaluating pricing strategies, or network contracting experience.
• Bachelors degree required/ Masters degree preferred in one of the following fields: Computer Science, Engineering, Statistics, Economics, Actuarial Science, Decision Sciences, Operations Research, Health Economics, Finance, Applied Mathematics, or highly related field of quantitative study.
• 5+ years of direct People Leadership experience.

Additional Information

Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: ​

• The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future. ​

• We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.​

• This job is eligible to participate in our long-term incentive programs. ​

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company’s sole and absolute discretion, consistent with applicable law.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community.  Equal Opportunity Employer/Veterans/Disabled. 

US & Puerto Rico only - to learn more, visit https://www.abbvie.com/join-us/equal-employment-opportunity-employer.html

US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:

https://www.abbvie.com/join-us/reasonable-accommodations.html

Compensation: 160500 to 305000 (USD) (YEARLY)