Director,Patient Care Advocacy

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving health care outcomes for all!  We promise to do what’s right, al-ways.

Position Summary: The Director of Patient Care Advocacy leads and manages a team of Patient Care Advocate Managers. This leadership role oversees the delivery of exceptional patient care, focusing on advocating for patients' needs, ensuring they receive the highest level of service, and supporting the PCA Manager team in navigating complex pharmacy benefit systems. The Director will work cross-functionally with internal teams, healthcare providers, and external stakeholders to continuously enhance patient care experiences and outcomes.

What you will do:

Leadership and Team Management:
•    Leads and manages a team of Patient Care Advocate Managers, fostering a culture of empathy, professionalism, and patient-centered care
•    Provides coaching, mentorship, and support to ensure the managers and their teams meet operational and performance goals while maintaining high levels of job satisfaction and retention
•    Develops and implements team performance metrics, continuously monitoring team activities, productivity, and overall impact on patient care
•    Conducts regular one-on-one meetings, performance reviews, and ongoing development opportunities for all team members
•    Collaborates with other leaders across the organization to ensure the PCA team aligns with broader company goals and strategies

Clinical and Operational Oversight:
•    Ensures all Patient Care Advocates and Managers are proficient in pharmacy and medical benefit structures
•    Oversees the training and continued education of the PCA teams to ensure they remain current with the requirements and eligibility criteria for copay assistance, prior authorization, appeals processes, and other key healthcare regulations
•    Monitors adherence to PBM policies and procedures to ensure compliance and accuracy in patient interactions
•    Reviews team performance and provide actionable feedback on the quality and impact of patient interactions, ensuring that best practices in problem resolution, advocacy, and education are followed

Stakeholder Engagement and Collaboration:
•    Serves as an escalation point for complex patient issues, providing guidance and support to PCA Managers in resolving difficult cases
•    Fosters and maintains strong relationships with internal stakeholders (e.g., operations, clinical teams, IT) and external stakeholders (e.g., healthcare providers, pharmacies, third-party financial assistance organizations) to improve patient care
•    Oversees the coordination of efforts between Patient Care Advocates, providers, pharmacies, and other community resources to streamline processes and enhance patient satisfaction
•    Works closely with the leadership team to assess trends in patient inquiries and needs, ensuring the PCA teams are proactive in offering the necessary support

Quality Assurance and Process Improvement:
•    Develops and implements quality assurance processes to ensure consistent, high-quality service is provided to all patients, maintaining compliance with all relevant regulations and standards
•    Conducts regular audits of PCA interactions, including phone calls, chats, and documentation, to ensure accuracy, compliance, and quality of service
•    Identifies opportunities for process improvements, utilizing data and feedback to optimize team workflows, patient engagement strategies, and resource allocation
•    Collaborates with other departments (e.g., IT, training, compliance) to improve operational efficiency and enhance the patient care experience

Reporting and Analytics:
•    Provides regular reports on team performance, key metrics, and patient satisfaction, highlighting areas of success and opportunities for improvement
•    Uses data analytics to assess team and patient outcomes, developing strategies to improve team effectiveness and patient satisfaction scores
•    Maintains accountability for departmental budget and resources, ensuring cost-effective operations while maintaining a high level of patient care

What you need:
•    Doctor of Pharmacy (Pharm.D.) degree from an accredited pharmacy school, or equivalent experience in clinical pharmacy practice
•    10+ years of proven leadership experience in healthcare, with a background in managing patient care teams, ideally within a PBM, insurance or healthcare provider setting
•    Exceptional communication and interpersonal skills, with the ability to effectively communicate complex medical information to patients and families 
•    Strong problem-solving skills and the ability to navigate complex healthcare systems. 
•    Empathy and compassion for patients, with the ability to provide emotional support during challenging situations
•    Knowledge of medical terminology, healthcare regulations, and insurance processes 
•    Proficient computer skills and the ability to use electronic medical record systems
•    Strong organizational skills and attention to detail
•    Ability to work collaboratively as part of a team and independently 
•    Easily adapt to changing priorities and manage multiple tasks simultaneously 
•    Maintain patient confidentiality and adhere to ethical standards
•    Ability to work in a private, quiet workspace for remote work to be performed
•    Flexibility to travel as required for team development, meetings, or conferences (10%-20%)

What you get:
•    To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes.
•    To work in a culture where people thrive because when OUR team thrives, OUR business thrives. 
•    Competitive compensation with health, dental, vision and other benefits.

Note:  
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.