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Position Purpose:

The Director/Senior Director, Government Accounts is a field-based market access role responsible for securing and optimizing coverage, reimbursement, and policy access for a medical benefit injectable product across state Medicaid fee-for-service (FFS) programs and Managed Medicaid health plans. This individual serves as the company's primary access architect within the government payer channel, navigating the intersection of federal Medicaid statute, state-level policy, and medical policy development to ensure patients receive uninterrupted, appropriately reimbursed access to therapy.

This individual will leverage deep government payer relationships to build Stoke's presence from the ground up-translating the clinical and economic value of zorevunersen to state Medicaid decision-makers and securing favorable coverage post approval.

This is a launch-oriented, high-visibility position that requires expertise in rare pediatric/neurological disease in the government channel. The role requires sophisticated knowledge of state Medicaid, new drug review timelines, DUR board processes, and the policy levers that determine speed to coverage for a launch product. The candidate will have the ability to operate nimbly within Stoke's growing commercial organization while partnering closely with our medical, commercial, government affairs, and patient advocacy colleagues.

Key Responsibilities:

Account Strategy & Launch Readiness

• Develop and execute pre-launch and launch-phase access strategies across Medicaid FFS and Managed Medicaid, establishing Stoke's credibility with state agencies ahead of FDA approval.
• Serve as Stoke's primary relationship owner and strategic point of contact across state Medicaid pharmacy and medical directors, DUR/P&T board members, and Managed Medicaid MCO leaders in priority states.
• Maintain a deep understanding of account-level policies, state drug review processes, competitive dynamics, decision timelines, and state priorities impacting access.
• Develop multi-year state Medicaid access plans that anticipate policy shifts, IRA pricing dynamics, and competitive changes, balancing state-by-state tactical execution with a national access strategy.

Government Payer Engagement & Coverage

• Proactively engage state Medicaid medical and pharmacy directors to secure informal billing guidance, coverage letters, or favorable fee-for-service payment determinations ahead of a permanent J code assignment.
• Monitor AMP-based reimbursement benchmarks, Medicaid Upper Payment Limits (UPLs), and state-specific drug fee schedules to provide payers with accurate, transparent pricing narratives that support appropriate reimbursement under the medical benefit.
• Monitor federal and state Medicaid policy developments-including CMS guidance, CMCS informational bulletins, state plan amendments (SPAs), and 1115/1915 waiver activity-and translate implications for brand access strategy.
• Educate government payers on clinical and economic value in frameworks meaningful to state Medicaid budget and policy decision-makers.

Reimbursement & J Code Management

• Educate Stoke's patient services and field reimbursement teams on navigating the miscellaneous J code environment at launch, including NDC crosswalk requirements and Medicaid-specific billing procedures.
• Serve as the internal subject-matter expert on Medicaid reimbursement dynamics for medical benefit products carrying a miscellaneous J code (J3490/J3590) pending assignment of a permanent, product-specific code.

Cross-Functional Collaboration

• Lead cross-functional collaboration with Policy, Advocacy, HEOR, Reimbursement, Trade & Distribution, and Marketing partners to advance access goals and account-level execution.
• Coordinate pull-through activities with Stoke's field teams, patient services, and reimbursement teams to ensure coverage decisions translate to patient access.
• Synthesize complex CMS guidance, state legislative changes, and IRA pricing developments into clear, actionable implications for the business, communicating effectively from field teams to executive leadership.
• Engage authentically with the Dravet syndrome patient and caregiver community and incorporate community insights into government payer engagement in a compelling and compliant manner.

Compliance & Governance

• Conduct all government account engagements in full compliance with company SOPs, OIG guidelines, PhRMA Code, the Anti-Kickback Statute, and applicable federal and state Medicaid regulations.
• Navigate the unique complexity of a first-in-class disease-modifying ASO therapy with no established Medicaid coverage precedent, finding creative and compliant paths to access.

Required Skills & Experience:

• Bachelor's degree required; advanced degree (MBA, PharmD, MPH) strongly preferred.
• 15+ years in pharma/biotech; minimum 8 years in government or Medicaid payer account management.
• Proven track record of achieving positive formulary and coverage outcomes for high-cost rare or specialty products in state Medicaid programs.
• Pre-launch government payer strategy experience-not just maintenance of established access.
• Proven ability to navigate and support medical benefit policy creation with Medicaid accounts.
• Hands-on experience navigating the miscellaneous J code environment (J3490/J3590) within Medicaid, including payer education on NDC crosswalk requirements, claims-level billing guidance, and coordination with FRMs and specialty distribution in a Medicaid context.
• Rare pediatric or rare neurological disease product launch experience; CNS or epilepsy payer experience a significant differentiator.
• Familiarity with 340B program intersections for rare disease products and duplicate discount compliance.
• Experience navigating Medicaid disability transition pathways (SSI/SSDI) for pediatric-onset neurological disease populations.
• Experience at a company building its commercial infrastructure for the first time-startup or early commercial-stage biotech.

Location(s):

Stoke is located in Bedford, MA and will be moving to a new location in Waltham, MA by the end of 2026. This is a remote / field-based position; proximity to a major US airport preferred. Travel: approximately 50% to state agency meetings, conferences, and company meetings.

Compensation & Benefits:

At Stoke Therapeutics, we are committed to offering a comprehensive, competitive and thoughtfully designed total rewards program.

The anticipated salary range for this role at the Director level is $238,000 - $268,000 and at the Senior Director level is $279,000 - $322,000. The final offer will be determined based on a variety of factors, including role scope, experience and qualifications, education, market benchmarks, internal equity, and geographic location. In addition to base salary, Stoke offers an annual bonus and equity participation.

Our benefits package includes medical, dental and vision insurance; life, long- and short-term disability insurance; paid parental leave; a 401K plan with company match, unlimited vacation time, tuition assistance and participation in our Employee Stock Purchase Program (ESPP).