BC Sector -LS-US Market access -Senior

Senior: US Market access (LS Sector team)

Experience: 4-7 years

Role Summary

We are hiring a Senior – Market Access (US) to support US-centric access strategy, payer engagement synthesis, pricing & reimbursement inputs, and evidence-gap analysis for pharmaceutical and biotech clients. The role focuses on the distinct U.S. ecosystem: commercial payers, regional & national Medicaid, Medicare Part A/B/D, PBMs, specialty pharmacies, IDNs, and private payers — plus private US HTA-like assessments (e.g., ICER) and value frameworks.

The Senior will translate payer requirements into pragmatic access strategies that inform evidence generation, pricing, contracting, and launch sequencing for the US market.

Key Responsibilities

• US Payer Landscape & Coverage Strategy
  • Map payer decision pathways across commercial payers, PBMs, Medicare Part D & B, Medicaid (state-level), and specialty pharmacies / IDNs.
  • Assess formulary access levers: formulary tiering, PA/step edits, specialty carve-outs, QLAs, site-of-care impacts, and utilization management.
  • Produce payer segmentation and prioritize target payers by likelihood-to-cover and commercial impact.
• Pricing & Reimbursement
  • Support US pricing inputs: commercial list price considerations, net price dynamics (rebates, discounts), ASP/WAC/ASP-ASP interactions where relevant.
  • Run price-sensitivity and revenue-impact scenarios for different contracting approaches (rebate levels, 340B impacts, discounting).
  • Work with global pricing to align US price corridors and launch sequencing.
• Evidence & HTA Assessment for US
  • Review and synthesize ICER reports, private payer coverage policies, Medicare NCDs/LCDs, and major commercial payer policy documents.
  • Map clinical and real-world evidence (RWE) requirements for coverage and formulary placement; identify evidence gaps and mitigation strategies.
  • Build evidence requirement matrices tailored to Medicare, Medicaid, PBMs and major commercial payers.
• Payer Research Synthesis & Recommendation
  • Interpret payer primary research outputs (if available) or third-party interviews to generate payer messaging, value drivers, and evidence sequencing.
  • Translate payer insights into actionable tactics: dossier content priorities, outcome sensitive contracting (risk-sharing/value-based agreements), prior authorization templates, and real-world study needs.
• Contracting & Access Solutions
  • Support design of contracting options: rebate structures, outcomes-based or indication-based contracts, risk-share constructs.
  • Model net price / access trade-offs and provide implementation considerations (data needs, measurement, operational feasibility).
• Launch & Lifecycle Access Planning
  • Develop US launch access playbooks: pre-launch payer engagement priorities, formulary pre-submissions, early evidence generation, and distribution/channel strategy (hub, specialty pharmacy, buy-and-bill vs buy-and-hold).
  • Monitor early-access signals post-launch and recommend tactical interventions.
• Cross-functional collaboration & delivery
  • Work closely with HEOR, RWE, PMR, Commercial Analytics, and client teams to align evidence-generation with access needs.
  • Create client-ready deliverables: payer landscape decks, evidence matrices, pricing impact models, payer-targeting lists, and one-page executive summaries.

Required Skills & Experience

Experience

• 4 – 7 years in US-focused market access, payer strategy, HEOR-support, commercial strategy, or consulting for pharma/biotech.
• Direct experience working with US payers / PBMs / Medicare / Medicaid / specialty pharmacies or supporting US launches.
• Exposure to launch planning and payer-facing clinical value narratives.

Technical Skills

• Strong Excel modelling skills for price / net-revenue simulations, scenario analysis, and sensitivity testing.
• Experience reading and synthesizing payer policies, NCD/LCDs, PBM formularies, and ICER-like reports.
• Familiarity with outcomes-based agreements and basic contracting economics.
• Comfort working with RWE inputs — understanding appropriate endpoints and real-world endpoints used by payers.

Domain Knowledge

• Deep understanding of US payer architecture: PBM formulary mechanics, Medicare Part B vs Part D reimbursement, hospital buy-and-bill, 340B, specialty pharmacy pathways, Medicaid MCOs and state carve-outs.
• Awareness of US regulatory touchpoints that affect access (coverage determinations, coding & billing implications such as CPT/HCPCS where relevant).

Soft Skills

• Consulting-quality problem structuring and hypothesis-driven thinking.
• Strong written and slide-based communication (clear, concise executive summaries).
• Stakeholder management and ability to communicate with US-based client teams across time zones.

Preferred (Good-to-Have)

• Experience supporting outcomes-based contracts or VBP pilots.
• Prior exposure to commercial contracting or rebate negotiation support.
• Familiarity with Medicare Part D formulary construction tools or PBM rebate architectures.
• Experience with commercial data sources for access (claims, specialty data, formulary libraries).
• Advanced HEOR familiarity (budget impact, cost-effectiveness basics) — not required but helpful.

What we look for

We look for people who can develop and implement creative solutions to challenging problems and work well with teams to accomplish it. We look for people with an entrepreneurial spirit: innovative by nature, always creating new approaches, products, services, and technologies. Helping clients solve tough problems and implement solutions requires strong intellectual abilities and rigor as well as a practical sense of what works and what does not. We seek people who strive to lead themselves, their teams, and their communities, and who can foster effective teamwork to drive results. Is this you?

What working at EY offers

At EY, we’re dedicated to helping our clients, from startups to Fortune 500 companies and the work we do with them is as varied as they are. You get to work with inspiring and meaningful projects. Our focus is education and coaching alongside practical experience to ensure your personal development. We value our employees, and you will be able to control your own development with an individual progression plan. You will quickly grow into a responsible role with challenging and stimulating assignments. Moreover, you will be part of an interdisciplinary environment that emphasizes high quality and knowledge exchange.

Plus, we offer:

• Support, coaching and feedback from some of the most engaging colleagues around
• Opportunities to develop new skills and progress your career
• Freedom and flexibility to handle your role in a way that’s right for you