Director of Patient Access

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Gifthealth

501 - 1000 employees

Founded 2020

🏥 Healthcare

📦 Logistics

💼 Consulting

💰 $40M Private Equity Round - GiftHealth on 2023-04

Healthcare • Logistics • Consulting

Gifthealth is a technology-enabled patient access and prescription fulfillment company that connects patients, prescribers, pharmacies, and pharmaceutical manufacturers through a unified digital platform. It streamlines enrollment, electronic benefits verification, e-prior authorization, and payment/affordability support while managing pharmacy fulfillment and patient support services. The platform also provides manufacturers with actionable data and insights on patient journeys and brand performance, driving faster, more reliable medication access.

📋 Description

• Own and continuously strengthen the prior authorization operating system between prescription and therapy initiation • Own prior authorization turnaround time, queue health, aging targets, performance monitoring, and corrective action • Serve as primary FRM point of contact and own the FRM partnership model • Troubleshoot stalled, denied, escalated, and systemic prior authorization issues • Own complex escalations across Client Success, Pharmacy Operations, Quality, and manufacturer partners • Review PA data and balanced performance metrics, including approval and denial rates, TAT, aging, denial reasons, quality, and rework • Maintain dashboards and management views for queue health, exceptions, and performance risks • Drive evidence-based process improvement, measurable pilots, standardization, and scaling • Partner on workflow and automation improvements with visible exceptions and human-rescue paths • Lead the multi-tiered Patient Access team, including Team Leads/Supervisors, FRM Liaisons, and PA Specialists/Coordinators • Develop team leads and supervisors as operational owners • Build hiring, onboarding, capacity planning, and performance management processes • Create career pathing, cross-training, and skill development plans • Partner with the Director of Patient Experience and collaborate with Pharmacy Operations, Intake & Automation, Quality, and Client Success • Represent patient access performance in leadership updates, client reviews, and program launches • Improve patient therapy-start speed while maintaining quality, compliance, and patient experience

🎯 Requirements

• Bachelor’s degree or equivalent combination of education and/or experience (Required) • 5+ years in prior authorization, patient access, or reimbursement within specialty pharmacy, PBM, or manufacturer hub/FRM environments • People leadership experience hiring, coaching, and managing performance through team leads or supervisors in a high-volume operation • Direct experience managing or partnering closely with Field Reimbursement Manager (FRM) teams • Strong analytical skills and ability to turn PA, TAT, aging, and performance data into action • Working knowledge of the payer and PBM landscape, prior authorization requirements, and specialty medication access barriers • Demonstrated ability to improve operational workflows using data, frontline input, and cross-functional partnership • Experience in a direct-to-patient or specialty dispensing pharmacy environment (nice-to-have) • Familiarity with hub services, bridge programs, or manufacturer-sponsored patient access programs (nice-to-have) • Experience building or improving PA workflows, SOPs, performance management routines, or automation-enabled processes from the ground up (nice-to-have) • No licensure required • May require availability or flexibility for escalations

🏖️ Benefits

• Remote work • Full-time employment • Flexibility or availability for escalations • Inclusive work environment • Equal employment opportunity

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