Senior Manager, Obesity Coverage and Value Strategy

Senior Manager, Obesity Coverage and Value Strategy

The Senior Manager Obesity and Related Conditions (OaR) Coverage and Value Strategy owns the U.S. payer coverage and value-marketing agenda for OaR. The role turns clinical, economic, patient and market evidence into segment and account-level access strategy, compelling payer communication and practical field pull-through that improves appropriate coverage and reduces access friction. The role owns prior-authorization and utilization-management analysis and supplies approved coverage assumptions to the Pricing Lead.

Core responsibilities:

• Lead the integrated U.S. coverage strategy across commercial, Medicare and Medicaid segments, including payer segmentation, access objectives, account priorities and plans to establish, improve and protect coverage.
• Define the desired coverage and utilization-management position, including formulary tier, prior authorization, step therapy, reauthorization, quantity limits and clinical criteria; assess patient-journey and business implications.
• Own prior-authorization and utilization-management analysis, including criteria benchmarking, documentation burden, patient-flow implications, approval and denial patterns, renewal requirements, administrative friction and alternative policy scenarios.
• Provide clear, approved coverage, prior authorization criteria , step and reauthorization assumptions to the Pricing Lead for gross to net (GTN) and contract modeling; explain changes and uncertainty without transferring ownership of the access analysis.
• Partner with Pricing, Contracting, Insights and field access teams to translate payer realities into coverage strategies, contracting objectives, pull-through plans and escalation priorities.
• Lead the U.S. payer value story and customer-specific value communication, connecting MariTide clinical profile, burden of obesity and related conditions, health-economic evidence, patient experience and affordability to payer decision needs.
• Develop, refresh and govern payer-facing materials and field tools, including value dossiers, payer presentations, objection handlers, coverage resources, FAQs, training content and account-planning aids through the appropriate review process.
• Lead payer, employer and market research to test coverage barriers, evidence needs, benefit-management expectations, value messages and evolving obesity policies; convert findings into prioritized actions.
• Collaborate with Health Economics Outcomes Research and Real World Evidence, Medical and Global Value and Access on evidence priorities, payer objections and evidence dissemination; identify evidence gaps that could improve coverage or reduce utilization burden.
• Track coverage performance and access Key Performance Indicators by segment and customer; diagnose barriers using formulary, claims, field and customer insight; mobilize accountable partners to close priority gaps.
• Shape value evidence and coverage implications for employer and consumer pathways when requested, while the Consumer Director and Employer Lead Director retain ownership of their strategies and relationships.
• Partner with Brand, Patient Access & Reimbursement on affordability and access education, consumer and Health Care Professional experience, and the clinical-operational handoffs required for patients to start and persist appropriately.
• Present concise coverage, evidence and value recommendations to the Director and appropriate launch or governance forums; make dependencies, uncertainties and decisions explicit.

What we expect of you

We are all different, yet we all use our unique contributions to serve patients. The professional we seek is someone with these qualifications.

Basic qualifications:

• Doctorate degree and 2 years of market access, value marketing, HEOR, payer strategy, reimbursement, pricing, contracting, finance, analytics or sales and marketing operations experience; OR
• Master’s degree and 4 years of market access, value marketing, HEOR, payer strategy, reimbursement, pricing, contracting, finance, analytics or sales and marketing operations experience; OR
• Bachelor’s degree and 6 years of market access, value marketing, HEOR, payer strategy, reimbursement, pricing, contracting, finance, analytics or sales and marketing operations experience; OR
• Associate’s degree and 10 years of market access, value marketing, HEOR, payer strategy, reimbursement, pricing, contracting, finance, analytics or sales and marketing operations experience; OR
• High school diploma or GED and 12 years of market access, value marketing, HEOR, payer strategy, reimbursement, pricing, contracting, finance, analytics or sales and marketing operations experience.

Preferred Qualifications:

• Experience in payer marketing, coverage strategy, managed markets, HEOR or value communication, patient access, or a payer, PBM or employer setting; launch experience in chronic, primary-care or cardiometabolic markets preferred.
• Strong working knowledge of U.S. pharmacy and medical benefits, formulary decision-making, prior authorization, step therapy, reauthorization, benefit design and access operations.
• Ability to interpret clinical