Jobs at Capricor Therapeutics

The Senior Director, Head of Payer Strategy & Engagement will lead the development and execution of U.S. payer strategy and account engagement in support of the anticipated launch of deramiocel, Capricor's lead cell therapy for Duchenne muscular dystrophy. The role is responsible for constructing the payer value platform, shaping coverage and contracting strategy across commercial, Medicare, and Medicaid segments, and leading the National Account Director team to deliver timely and appropriate payer access decisions. This leader partners closely with Pricing & Contracting Operations, Market Access Analytics, Trade & Patient Services, Medical Affairs, HEOR, Legal, and Finance, as well as external payer leadership, advocacy organizations, and market access vendors.

Payer Strategy & Value Platform:

• Develop the U.S. payer strategy across commercial, Medicare, and Medicaid segments, aligned with Capricor's launch and access objectives.
• Construct the deramiocel payer value platform, including AMCP dossiers, value decks, budget-impact models, and policy response tools.
• Identify pricing and reimbursement analogues to support value and access decisions for a high-cost, one-time treatment rare-disease therapy.

Coverage, Coding & Reimbursement:

• Drive the product-specific HCPCS code application and ICD-10 coding initiatives to support clear reimbursement pathways.
• Monitor healthcare legislative and policy trends; assess impact and develop responses to address access barriers.
• Partner with Trade & Patient Services on buy-and-bill, specialty pharmacy, and site-of-care strategy for infused cell therapy.

Account Engagement & Contracting:

• Lead the National Account Director team in account-level engagement with national and regional payers, PBMs, Medicaid plans, and IDNs.
• Develop contracting strategy and oversee execution of commercial, Medicaid, and outcomes-based arrangements in partnership with Pricing & Contracting Operations and Legal.
• Establish payer account plans, productivity measures, and execution cadence.

Cross-Functional Partnership & Compliance:

• Align HEOR, real-world evidence, and clinical evidence-generation efforts with payer and HTA expectations.
• Partner with Marketing and Field teams to develop payer-focused tools, messaging, and training.
• Ensure all payer engagement activities follow Capricor compliance standards and applicable regulations.
• Represent Capricor at key industry conferences (e.g., AMCP, PCMA, ISPOR, Asembia).
• Perform other duties as assigned.

Team Management:

• Directly leads the National Account Director team supporting the U.S. payer footprint.
• Provides coaching, development, and performance management to payer-facing leaders.
• Owns workload planning, training, and staffing to support launch readiness and post-launch scale.
• This team will expand as the business scales; the Senior Director will lead future hiring and organizational development.

Working Conditions:

• Field-based (remote) position; expected to be in the San Diego, CA office approximately two to three times per quarter, or as required by business need.
• Domestic travel approximately 30 to 50% for payer engagement, conferences, and internal meetings.
• Extended periods of computer-based work, including video conferencing and collaborative software platforms.

Required Qualifications:

• Bachelor's degree required; advanced degree (MBA, MPH, PharmD, or related) strongly preferred.
• 12+ years of biopharmaceutical experience, including 5+ years in U.S. market access and reimbursement leadership.
• Rare-disease or specialty or advanced-therapy launch experience required.
• Hands-on experience with HTA, U.S. payer engagement, patient and provider access, HEOR, and medical-benefit reimbursement and coding.
• Strong analytical capabilities, including working knowledge of government pricing methodologies and supporting regulations.
• Demonstrated ability to lead account teams and execute complex multi-stakeholder contracting initiatives.
• Outstanding executive presence and the ability to engage payer leadership effectively.

Preferred Qualifications:

• Cell or gene therapy payer engagement experience.
• Global or international market access experience.
• Experience leading outcomes-based or milestone-based contracting structures.
• Established senior-level relationships across national and regional commercial payers, PBMs, and Medicaid plans.

Core Competencies:

• 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.