Director, Client & 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 and Client Care Advocacy leads and manages teams of Patient Care Advocate Managers and Client Managers, ensuring exceptional patient care, client satisfaction, and strategic management of relationships with clients, consultants, brokers, and partners. This role focuses on delivering best-in-class service by fostering a culture of empathy, professionalism, and operational excellence while navigating complex pharmacy benefit systems. The Director works cross-functionally with internal teams and external stakeholders to continuously enhance patient care, client relationships, and outcomes.

What you will do:
Leadership and Team Management:
•    Lead, coach, and mentor a team of Patient Care Advocate Managers and Client Managers, fostering a culture of empathy, professionalism, and client-centered care
•    Develop and implement team performance metrics, monitoring activities, productivity, and impact on patient and client care
•    Conduct regular one-on-one meetings, performance reviews, and professional development opportunities for team members
•    Provide coaching, mentorship, and support to ensure operational and performance goals are met while maintaining high levels of job satisfaction and retention
•    Partner with cross-functional teams to align team objectives with broader organizational strategies

Patient Advocacy and Care Management:
•    Ensure Patient Care Advocates and Managers are proficient in pharmacy and medical benefit structures, including copay assistance, prior authorization, and appeals processes
•    Monitor adherence to PBM policies and procedures, ensuring compliance and accuracy in patient interactions
•    Serve as an escalation point for complex patient issues, providing guidance to resolve challenging cases effectively
•    Oversee training and continued education for teams, ensuring proficiency in healthcare regulations and patient advocacy best practices
 
Client Management and Engagement:
•    Partner with internal teams, including operations, clinical, IT, and analytics, to deliver seamless service to patients and clients
•    Collaborate with cross-functional teams on initiatives such as sales, reporting, proposals, and formulary strategies
•    Foster cross-functional work teams to drive results aligned with the organization’s strategic plan

Quality Assurance and Process Improvement:
•    Develop and implement quality assurance processes to ensure high-quality service to patients and clients, maintaining compliance with relevant regulations and standards
•    Conduct regular audits of team interactions and documentation, ensuring accuracy and consistency
•    Identify and lead process improvement efforts to optimize workflows, engagement strategies, and resource allocation

Reporting and Analytics:
•    Provide regular reports on team performance, patient and client satisfaction, and key metrics, highlighting areas for improvement
•    Use data analytics to assess outcomes and develop strategies to improve effectiveness and satisfaction scores
•    Maintain accountability for departmental budgets, ensuring cost-effective operations without compromising quality

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 diverse teams in patient care or client facing roles within the PBM industry, insurance or healthcare provider setting
•    Proven ability to solve complex problems, manage escalations, and serve as a point of contact for team members and stakeholders
•    Strong communication, interpersonal, and problem-solving skills
•    Knowledge of medical terminology, healthcare regulations, and insurance processes
•    Proficiency in analytics, pricing strategies, and electronic medical record systems
•    Demonstrated ability to work collaboratively across departments and independently
•    Empathy and compassion for patients, coupled with strategic thinking for client management.
•    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 (20%-40%)

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, including equity, 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.