Own the access and coverage strategy for an assigned set of national and regional payers, PBMs, and IDN accounts; develop and execute account-specific business plans aligned with Capricor's launch and access objectives.
Lead value-based clinical, HEOR, and budget-impact discussions with medical directors, pharmacy directors, P&T committees, and policy teams to drive timely and appropriate medical policy positions.
Navigate the buy-and-bill, medical-benefit, and specialty-pharmacy access pathways unique to infused cell therapies.
Partner with the Market Access Leadership team on Pricing & Contracting appropriate to a rare-disease, cell therapy economics profile.
Lead account-level negotiations on coverage, coding, utilization management, and contracting in coordination with Market Access leadership.
Build and maintain trusted senior-level relationships with payer leadership across assigned accounts.
Deliver compelling, compliant clinical, economic, and patient-centered presentations using AMCP dossiers, value decks, and approved access materials.
Monitor coverage decisions, medical policy changes, and utilization management positions across assigned accounts; flag risks and opportunities in real time.
Payer account (government & commercial) profiling, business plan creation, and strategic execution with top payer / customer accounts.
Establish access goals, productivity measures, and ensure account plans are created and executed annually.
Internal Coordination & Intelligence
Partner with Trade & Patient Services to ensure smooth coverage navigation, prior authorization, and case management for patients in the assigned geography.
Partner with Sales, Medical Affairs, and MSLs to align account-level engagement with broader commercial and scientific activities, in full compliance with channel and engagement rules.
Provide structured payer intelligence and account insights back to Market Access leadership to inform pricing, contracting, and strategic positioning.
Maintain accurate account plans, CRM activity, and reporting cadence; participate in business reviews and launch readiness forums.
Perform other duties as may be assigned from time to time.
Bachelor's degree required; advanced degree (MBA, PharmD, MPH, or related) preferred.
10+ years of biotech / pharma U.S. Market Access experience, including 5+ years in a National Account Director or equivalent senior payer-facing role.
Demonstrated success securing coverage for high-cost specialty, rare disease, or cell / gene therapy products in the medical-benefit channel.
Established senior-level relationships across national and regional commercial payers, PBMs, Medicaid plans, Medicare / MACs and IDNs.
Working knowledge of buy-and-bill economics, specialty pharmacy distribution, J-code / HCPCS coding, prior authorization workflows, and medical policy development.
Strong analytical skills, including the ability to interpret HEOR, budget impact, and value-based contracting models.
Executive presence and the ability to operate independently across senior external stakeholders.
Experience supporting a U.S. product launch in rare disease or advanced therapy.
Experience working with State and Managed Medicaid plans.
Prior cell or gene therapy payer engagement experience.
Experience operating in a pre-commercial or early commercial company with limited infrastructure.
Strong problem-solving and decision-making ability.
Vendor management and negotiation skills.
Ability to work in a fast-paced, rapidly scaling environment.
Exceptional attention to detail and documentation discipline.
Ability to influence without authority across cross-functional teams.
Field-based (remote) position based in or near the assigned territory; territory geography determined at time of hire.
Domestic travel approximately 50 to 75% for payer engagement, internal meetings, and industry conferences (AMCP, Asembia, PCMA).
Periodic presence at Capricor's San Diego HQ (approximately 2 to 3 times per quarter) or as required by business need.
Why Capricor?
Capricor Therapeutics is advancing cell and exosome-based therapies with a focus on serious diseases where patients and families need new treatment options. Our work is grounded in scientific rigor, collaboration, and a shared commitment to moving meaningful therapies forward. Joining Capricor means being part of a mission-driven team working at the intersection of innovation, execution, and patient impact.
Come Work With Us
At Capricor, you’ll join a collaborative environment where employees are encouraged to contribute, grow, and help build the systems, science, and operations needed to support our next stage of growth. We value people who are thoughtful, accountable, hands-on, and motivated by work that can make a real difference.
Recruiting Fraud Notice
Capricor does not use Skype for interviews or recruiting activities. Candidates will only be contacted by someone using an official Capricor email address ending in @capricor.com. Capricor will never ask candidates to send money, deposit a check, purchase equipment, or provide payment for any reason as part of the recruiting or onboarding process.
Notice to Recruiting Agencies
Capricor Therapeutics does not accept candidate submissions or referrals from recruiting agencies, staffing firms, or third-party recruiters without express written approval from Talent Acquisition and a fully executed agreement with Capricor. Agencies that contact hiring managers directly, solicit business, or submit candidates without prior approval will not be considered for engagement. Any unsolicited submissions will become the property of Capricor Therapeutics, and no fees will be paid for candidates hired as a result of such submissions. We appreciate your cooperation and respect for this policy.
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