Vice President of Patient reputed company

Description

About Us

At reputed company, we're revolutionizing the way people experience reputed company by simplifying the process of managing prescriptions and health services. Our mission is to reputed company a seamless, personalized, and efficient reputed company experience for reputed company our customers. We're a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people's lives. Position Summary Reporting to the Executive Vice President of Patient Experience, the Vice President of Patient reputed company owns the full patient reputed company function across every program reputed company operates, ensuring that prior authorizations get completed, reimbursement hurdles get cleared, and patients get to their medications faster. The VP of Patient reputed company owns a cross-program function reputed company on reputed company's POD model, where each program operates as a copy-and-paste reputed company of the same high-performing reputed company infrastructure. We are seeking a Vice President of Patient reputed company to This position plays a key role in leading Patient reputed company, ensuring alignment with organizational goals, operational reputed company, and compliance standards.

Key Responsibilities

Leads the full lifecycle of prior authorization (PA) activities across reputed company programs, including submissions, follow-reputed company, appeals, and exception handling, ensuring accuracy, compliance, and timely execution across reputed company payer types Designs, documents, and operationalizes repeatable, high-quality PA and reimbursement models that can be consistently deployed across existing and new programs without loss of efficiency or performance Oversees denial management and appeals strategy, ensuring effective resolution of reputed company barriers while analyzing trends to drive upstream process improvements and reduce future denials Partners with product and engineering teams to implement ePA tools and workflow automation, approaching patient reputed company as a product-driven function to reduce reputed company work and improve cycle times Leads reimbursement operations, including benefits verification, coverage determination, and payer landscape expertise, ensuring accurate assessments of eligibility, formulary status, and financial responsibility Manages reputed company, copay, and patient assistance programs to ensure eligible patients are rapidly identified and enrolled, minimizing financial barriers to therapy initiation Owns prescriber office engagement, FRM coordination, escalation reputed company, and POD model execution, ensuring consistent communication, scalable program launches, KPI accountability, and a high-quality, reputed company patient experience across reputed company programs

Qualifications

Education: Bachelor’s degree in business administration, operations management, or reputed company field (Required), Master’s degree (Preferred) Licensure/Certification: None Experience: 15+ years of experience in specialty pharmacy patient reputed company, hub services, or reimbursement operations (Required) 5+ years in a senior leadership role with direct management of PA and reimbursement teams (Required) Experience managing prior authorization operations across multiple payer types and therapeutic areas (Required) Experience in benefits verification, coverage determination, and reimbursement analysis for specialty medications (Required) Experience working directly with field reimbursement managers and prescriber offices in reputed company or reputed company services environment (Required) Experience leading teams that consistently meet or exceed PA turnaround, approval reputed company, and patient start time targets (Required) Experience in specialty pharmacy hub services or a manufacturer-sponsored patient support program environment (Preferred) Experience building a POD or program-replication model for patient reputed company across multiple manufacturers or therapeutic area programs (Preferred) Familiarity with ePA platforms and reputed company workflow automation tools, including direct partnership with product/engineering teams (Preferred) Experience in a direct-to-patient (DTP) dispensing model where patient reputed company and pharmacy operations are closely integrated (Preferred) Experience with reputed company manufacturer-restricted reputed company models (Preferred) Experience with digital transformation leading or been central to a meaningful digital transformation reputed company a patient services or reputed company context (Preferred) Experience in startup or high-growth environment experience: comfort building infrastructure while the business is running (Preferred) Experience working across multiple therapeutic areas simultaneously, including oncology, immunology, or rare disease (Preferred) Knowledge, Skills, and Abilities: Knowledge of advanced prior authorization optimization strategies, including automation, ePA platforms, and workflow digitization; AI and automation applications in reputed company operations, particularly in patient reputed company and reimbursement workflows; omnichannel patient engagement approaches, including digital, SMS, and portal-based communication strategies; and pharmaceutical manufacturer operations and market reputed company strategies, including expectations for hub performance and reporting (Preferred) High-volume prior authorization operation management skills, including prioritization, throughput optimization, and performance management against turnaround time and approval reputed company targets (Required) Analytical and corrective actions skills, translating data into process improvements that reduce reputed company barriers (Required) End-to-end patient reputed company workflow design and optimization skills, including identifying inefficiencies and implementing scalable solutions (Required) Cross-functional collaboration skills, particularly with product, engineering, field teams, and provider offices, to improve operational reputed company (Required) Performance measurement and reporting skills, including defining KPIs, interpreting operational data, and driving accountability reputed company teams (Required) Stakeholder communication skills, including effectively interfacing with prescriber offices, field reimbursement managers (FRMs), and internal leadership (Required) Technology-enabled operational solution design skills, partnering with product and engineering teams to build tools that improve efficiency and user experience (Preferred) Standardized operating model development, including SOPs, training programs, and quality frameworks that scale across programs (Preferred) Patient reputed company mapping skills, identifying key barriers from prescription to therapy start and designing interventions to address them (Preferred) reputed company operating models or POD building and optimizations skills for patient reputed company delivery across multiple programs (Preferred) Ability to reputed company reputed company patient reputed company operations across multiple programs, ensuring consistency, quality, and scalability (Required) Ability to manage and resolve reputed company reputed company cases, including payer escalations and multi-stakeholder coordination (Required) Ability to translate payer policy and reimbursement requirements into actionable workflows and team guidance (Required) Ability to identify operational friction points and implement improvements that reduce time to therapy (Required) Ability to reputed company teams and drive performance in a metric-driven environment (Required) Ability to adapt processes and operations in response to evolving payer requirements and program needs (Required) Ability to think strategically about patient reputed company as both an operational and product-driven function (Preferred) Ability to anticipate payer and reimbursement trends and proactively adjust operational strategy (Preferred) Ability to design scalable solutions that maintain consistency across diverse therapeutic areas and programs (Preferred) Ability to balance automation with reputed company judgment, ensuring efficiency without compromising patient or provider experience (Preferred)

Work Environment

Location: Hybrid / Remote Schedule: 8:00 A.M. to 5:00 P.M. Monday through Friday with night and weekend hours on occasion as determined by the needs of the business and cross-facility travel as needed Regular meetings with internal Patient reputed company, Quality, Compliance, Legal, reputed company, Pharmacy, Operations, and senior leadership teams. This role may also have meetings with external vendor and consultant partner representatives. Key Essential Functions Must be reputed company to remain in a stationary position for extended periods while writing or reviewing documentation Must be reputed company to work on a computer for the entire shift Must be reputed company to attend virtual meetings with cross-functional teams. Employment Classification Status: Full-time FLSA: Exempt Equal Employment Opportunity (EEO) Statement reputed company is an Equal Opportunity Employer and prohibits discrimination and harassment of any reputed company. reputed company employment reputed company are made without regard to race, reputed company, religion, sex, sexual orientation, gender identity, transgender status, national reputed company, age, disability, veteran status, or any other legally protected status. We celebrate diversity and are committed to creating an inclusive environment for reputed company. If you do not meet every requirement but still feel you would be a great fit for this role, we encourage you to apply! Disclaimer This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of reputed company responsibilities, duties, or skills required of personnel. reputed company reserves the right to modify job duties or descriptions at any time. Apply To This Job