Director, Reimbursement Services/Patient Support (Specialty)
About The Position
The Director, Reimbursement Services & Patient Support provides strategic leadership, development, implementation, and oversight of patient support, reimbursement, and hub service programs. The role leads patient access initiatives and ensures patients, healthcare providers, and provider offices receive support throughout the treatment journey. The Director provides strategic direction to Field Reimbursement Management (FRM) and Hub Services organizations, partnering with Market Access, Marketing, Legal, Compliance, Commercial, payer teams, and external vendors. The role identifies patient access barriers, develops solutions aligned with brand strategy and market needs, and oversees program strategy, vendor relationships, service operations, performance measures, and process improvements. This is a field-based, remote role with travel of up to 30%, including overnight travel, as dictated by business needs, and attendance at company-sponsored events, meetings, and conferences.
Requirements
- Bachelor's degree required.
- At least 10 years of healthcare, biotechnology, or pharmaceutical industry experience.
- At least 5 years of progressive experience in Hub Services, Patient Support Programs, and/or Field Reimbursement.
- Demonstrated ability to lead large-scale patient support and reimbursement programs.
- Strong knowledge of pharmaceutical market access and reimbursement landscapes.
- Deep understanding of Commercial, Medicare, and Medicaid benefit structures.
- Extensive experience with provider reimbursement, coding, billing, prior authorizations, appeals, and hub operations.
- Excellent communication, presentation, and relationship-building skills.
- Proven ability to influence cross-functional stakeholders.
- Strong organizational skills and ability to manage multiple priorities and deadlines.
- Experience leading teams in a highly regulated healthcare environment.
- Proficiency with Microsoft Office Suite, including PowerPoint, Word, Excel, and Outlook.
- Ability to use CRM and reimbursement support platforms, patient support and hub reporting systems, and data analytics and dashboard reporting tools.
Nice To Haves
- Experience within Oncology, Immunology, Rare Disease, or Specialty Pharmaceuticals.
- Advanced degree such as an MBA, PharmD, MPH, MS, or equivalent.
Responsibilities
- Establish deployment strategies for in-house or outsourced Field Reimbursement Management to maximize efficiency and effectiveness.
- Serve as liaison between Meitheal and outsourced Hub Services and Patient Support Program providers.
- Direct reimbursement support strategy, including vendor selection, process design, and program optimization.
- Develop patient access solutions to improve speed to therapy and reduce reimbursement barriers.
- Partner with Market Access, Marketing, Legal, Compliance, and Commercial teams to develop patient support programs.
- Lead development of reimbursement and patient support educational materials.
- Provide organizational expertise on reimbursement trends, legislative changes, and regulatory developments.
- Collaborate with payer teams to align reimbursement support programs with payer coverage policies.
- Serve as an internal resource for access, reimbursement, and patient affordability initiatives.
- Provide strategic oversight of patient access and support service center operations.
- Develop and implement virtual reimbursement support models operated through hub partners.
- Establish and maintain relationships with hub vendors and service providers.
- Develop and monitor Key Performance Indicators (KPIs) and Service Level Agreements (SLAs).
- Conduct regular business reviews and implement process improvements to enhance patient and provider experiences.
- Provide strategic direction to maximize field reimbursement team effectiveness.
- Work with Field Reimbursement partners to identify and resolve reimbursement and coverage challenges.
- Guide development of reimbursement tools and resources for healthcare providers.
- Provide expertise on payer medical policies, reimbursement pathways, coding, billing, prior authorizations, and appeals.
- Monitor industry trends affecting patient access and affordability, including IRA-related benefit changes, copay accumulators, maximizers, and Alternative Funding Programs.
- Participate in industry conferences and professional organizations as appropriate.
- Develop educational strategies to help external stakeholders understand coverage policy changes.
- Ensure activities comply with HIPAA regulations, company policies, and applicable healthcare laws.
- Travel up to 30%, including overnights, as dictated by business need, and attend company-sponsored events, meetings, and conferences.
Benefits
- Competitive pay
- Medical insurance
- Dental insurance
- Vision insurance
- Flexible spending accounts
- Long- and short-term disability insurance
- Life insurance
- 401(k) plan with match
- Competitive paid time off
- Company-paid holidays
- Paid parental leave, including maternity and paternity leave
- Employee assistance program
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What This Job Offers
Job Type
Full-time
Career Level
Director
