Director, National Accounts (ESI/Cigna) – MASH
Madrigal is a biopharmaceutical company focused on delivering novel therapeutics for metabolic dysfunction-associated steatohepatitis (MASH), a serious liver disease that can progress to cirrhosis, liver failure, need for liver transplantation and premature mortality. Every member of our Madrigal team is connected by our shared purpose: leading the fight against MASH.
Madrigal’s medication, Rezdiffra (resmetirom), is a once-daily, oral, liver-directed THR‑β agonist designed to target key underlying causes of MASH. Rezdiffra is the first and only medication approved by both the FDA and European Commission for the treatment of MASH with moderate to advanced fibrosis (F2 to F3). An ongoing Phase 3 outcomes trial is evaluating Rezdiffra for the treatment of compensated MASH cirrhosis (F4c).
Position Summary
The Director, National Accounts is responsible for ensuring national payer accounts deliver a seamless, high-quality access experience that supports provider choice and appropriate patient care across the MASH portfolio. This role reports to the Executive Director, National Accounts and partners with account leaders to translate complex data, contract structures, and market dynamics into actionable insights that remove barriers to access. The Director ensures payer contracts perform as intended, enabling access without unnecessary restrictions and optimizing the patient journey from prescription to therapy initiation. As a strategic partner, this individual elevates account management from operational oversight to proactive identification of access gaps, performance risks, and opportunities to improve provider and patient experience. The role may include direct responsibility for a select payer account.
Key Responsibilities
- Lead analytics for national payer and PBM accounts, including coverage quality, utilization management, approval rates, time to therapy, abandonment, and pull-through.
- Monitor performance against contracts, forecasts, and access objectives; identify gaps, risks, and opportunities.
- Oversee rebate validation, contract performance, and downstream analytics to ensure alignment with financial and contractual terms.
- Partner with Pricing & Contracting on accruals, forecasting, reconciliation, and gross‑to‑net performance; resolve discrepancies with clear recommendations.
- Develop and maintain dashboards, QBRs, executive updates, formulary trackers, and standardized reporting tools.
- Conduct root‑cause analyses of access challenges across payer, provider, field, patient support, specialty pharmacy, and claims data.
- Collaborate with Field Reimbursement, Specialty Pharmacy, Trade, RADs, KADs, and Sales to convert payer wins into real‑world access.
- Support pre‑deal analytics and scenario modeling to ensure future contracts align with access, operational, and financial goals.
- Translate complex data into clear, actionable insights for leadership and cross‑functional teams.
- Support payer, PBM, and GPO engagements with performance insights and business reviews.
- May directly manage a select payer account.
Qualifications
- Bachelor’s degree required; advanced degree (MBA, MPH, PharmD, or similar) preferred.
- 10+ years relevant pharmaceutical or healthcare related work experience.
- 5+ years of those years should be in market access, payer strategy, account management, analytics, contracting, finance, or related roles.
- Strong understanding of payer contracting, rebates, formulary management, prior authorization, specialty pharmacy, and gross‑to‑net.
- Proven ability to synthesize complex data into clear insights and execution plans.
- Experience developing dashboards, business reviews, and performance reporting.
- Strong communication, analytical, and cross‑functional collaboration skills.
- Proficiency in Excel and PowerPoint required; experience with payer or claims data platforms preferred.
- Role requires up to 30% domestic travel.
- Alignment with Madrigal’s mission and values.
Benefits & Compensation
Madrigal’s Total Rewards strategy is based on a biotech industry peer group comparator and is inclusive of base pay, bonus and equity. Our equity offers meaningful opportunity allowing our employees to share in the success they help create. By aligning individual and company performance, we empower employees to think like owners, giving them a stake in the organization. All full‑time employees receive equity, which we believe reinforces our ownership culture. Base salary is determined by several factors including the candidate’s qualifications, skills, education, experience, business needs and market demands. As of the date of this posting, a good faith estimate of the current pay scale for this position, applicable to all candidates, is $223,000 to $271,000 per year. We comply with all applicable minimum wage laws. Full‑time employees are also eligible for comprehensive benefits, including flexible paid time off, medical, dental, vision and life/disability insurance, and 401(k) offerings (i.e., traditional, Roth, and employer match) in accordance with applicable plans. We also offer additional voluntary benefits like supplemental life insurance, legal services, and other offerings. In addition, we offer mental health benefits through our Employee Assistance Program for employees and their family. The company also provides other benefits in accordance with applicable federal, state, and local laws.
EEO & Accommodations
Madrigal is an Equal Opportunity Employer. All employment is decided on the basis of qualifications, merit, and business need. Applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex gender identity, sexual orientation, national origin, age, disability, protected veteran or disabled status, or other characteristic protected by applicable federal, state, or local law. We are committed to providing reasonable accommodations for individuals with disabilities throughout the hiring process. If you need assistance, please contact
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