[Hiring] Senior Manager, Obesity Coverage and Value Strategy @Amgen

Role Description

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.

• 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.

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.

Requirements

• 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 trials, real-world evidence and health-economic analyses and translate them accurately for payer coverage and utilization-management decisions.
• Demonstrated experience developing compliant payer or access materials and enabling customer-facing teams through training and pull-through tools.
• Strong strategic thinking, synthesis, facilitation, writing and presentation skills; able to independently lead a defined strategic workstream and influence in a matrixed launch environment.

Benefits

• A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts.
• A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan.
• Stock-based long-term incentives.
• Award-winning time-off plans.
• Flexible work models where possible.