Director of Patient Access

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership and enhance the prior authorization operating system that connects prescription and therapy initiation.

• Manage prior authorization turnaround times, queue health, aging targets, performance monitoring, and implement corrective actions.

• Act as the primary contact for FRM and manage the FRM partnership model.

• Address and resolve stalled, denied, escalated, and systemic prior authorization challenges.

• Handle complex escalations across Client Success, Pharmacy Operations, Quality, and manufacturer partnerships.

• Analyze PA data and balanced performance metrics, including approval and denial rates, turnaround time, aging, denial reasons, quality, and rework.

• Maintain dashboards and management views to monitor queue health, exceptions, and performance risks.

• Lead evidence-based process improvements, measurable pilots, standardization, and scalability efforts.

• Collaborate on workflow and automation enhancements, ensuring visibility of exceptions and human-rescue paths.

• Guide the multi-tiered Patient Access team, comprising Team Leads/Supervisors, FRM Liaisons, and PA Specialists/Coordinators.

• Cultivate the development of team leads and supervisors to become operational owners.

• Establish hiring, onboarding, capacity planning, and performance management processes.

• Design career pathing, cross-training, and skill development initiatives.

• Collaborate with the Director of Patient Experience and work alongside Pharmacy Operations, Intake & Automation, Quality, and Client Success.

• Present patient access performance during leadership updates, client reviews, and program launches.

• Enhance the speed of patient therapy initiation while ensuring quality, compliance, and a positive patient experience.

⛳️ Requirements

• Bachelor’s degree or a relevant combination of education and/or experience (Required).

• Over 5 years of experience in prior authorization, patient access, or reimbursement within specialty pharmacy, PBM, or manufacturer hub/FRM environments.

• Proven people leadership experience in hiring, coaching, and managing performance through team leads or supervisors in a high-volume setting.

• Direct experience managing or closely collaborating with Field Reimbursement Manager (FRM) teams.

• Strong analytical capabilities with the ability to convert PA, turnaround time, aging, and performance data into actionable insights.

• Familiarity with the payer and PBM landscape, prior authorization requirements, and barriers to specialty medication access.

• Demonstrated success in enhancing operational workflows through data analysis, frontline input, and cross-functional collaboration.

• Experience in a direct-to-patient or specialty dispensing pharmacy environment (preferred).

• Knowledge of hub services, bridge programs, or manufacturer-sponsored patient access initiatives (preferred).

• Experience in developing or refining PA workflows, SOPs, performance management routines, or automation-enabled processes from the ground up (preferred).

• No specific licensure required.

• May require availability or flexibility for escalations.

🏝️ Benefits

• Remote work options.

• Full-time employment status.

• Flexibility or availability for escalations.

• An inclusive work environment.

• Equal employment opportunities.