Shields Health Solutions - Director, Patient Support Center (Prior Authorization & Financial Assistance team)

Remote - USA1w ago

Requirements

• 7+ years of leadership experience in healthcare operations and/or pharmacy operations, with a track record of driving efficiency and performance. • 5+ years of experience leading large-scale operations teams (50+ team members) highly preferred, with a demonstrated ability to build and develop high-performing teams. • Proven experience collaborating with healthcare professionals, including physicians, nurses, and clinical staff, in hospital and/or provider settings (highly preferred). • Expertise in process development, process mapping, and process improvement, with a strong focus on optimizing pharmacy operations and enhancing patient outcomes. • Self-directed and highly capable of managing complex operations with limited direct oversight, while driving strategic initiatives. • Experience in specialty pharmacy operations is highly preferred, with a strong understanding of specialty refill management, prior authorization workflows, benefits investigations, and patient financial assistance. • Prior contact center operations experience or similar type experience would be helpful (but not required) • Executive Presence & Influence – Ability to influence without direct authority, collaborating effectively with regional leaders, on-site clinical staff, and business partners to drive alignment and achieve strategic goals. • Decision-Making & Negotiation – Skilled in making high-impact decisions and negotiating with senior leaders to achieve mutually beneficial outcomes while maintaining organizational priorities. • Leadership & Team Development – Ambitious leader with a proven ability to inspire, mentor, and develop Patient Support Center (PSC) team leaders and Patient Support Advocates fostering a high-performance culture. • Operational & Strategic Management – Strong operational acumen with the ability to evaluate trends, assess key performance metrics, and identify opportunities for continuous improvement in pharmacy operations. • Performance Management – Experienced in managing and coaching teams to meet and exceed quantitative metrics while ensuring clinical quality and patient-centered outcomes. • Training & Employee Engagement – Adept at designing and delivering training programs, leading by example, and leveraging motivational techniques to enhance employee engagement and professional growth. • Patient-Centered & Quality-Focused – Committed to delivering exceptional patient care, ensuring operational excellence, and maintaining high integrity, attention to detail, and accountability. • Effective Communication & Emotional Intelligence – Strong listening, teaching, and communication skills, with the ability to build relationships, foster collaboration, and resolve challenges with empathy and professionalism. • Change Management & Problem-Solving – Open-minded and adaptable change agent with a creative, solutions-oriented mindset, willing to take initiative and drive process improvements in a fast-paced environment. • Confidentiality & Professionalism – Highly discreet and trustworthy, handling sensitive health information with the utmost confidentiality and compliance with HIPAA regulations. • California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy. • By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. • Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Responsibilities

• Operational Leadership & Strategy • Oversee daily operations related to Specialty Pharmacy prior authorization and patient financial assistant operations. Other expanded responsibilities could include benefits investigations, refill management, patient outreach calls, ensuring efficiency and compliance with industry’s best practices. • Develop and implement scalable operational strategies that enhance service delivery, productivity, and patient support outcomes. • Lead and facilitate strategic discussions with regional and senior leadership teams to identify challenges, develop solutions, and drive continuous operational improvements. • Monitor and manage budgets, ensuring operational performance targets are met while maintaining a patient-centered approach. • Drive continuous process improvement initiatives by assessing workflows, identifying inefficiencies, and implementing best practices across the broader team. • Leverage technology solutions (CRM platforms, automated refill systems, data analytics, and other technology that will drive efficiency and scalability) • Provide visibility and career advancement opportunities through leadership training, succession planning, and mentorship programs. • Team Leadership & Talent Development • Build, inspire, and develop a high performing, engaged team by providing clear direction, motivation, and professional growth opportunities. • Provide coaching, feedback, and development to direct reports, including PSC Supervisors, Regional Team Leads, and Patient Support Advocates, to ensure alignment with performance expectations. • Create individualized development plans for team members, leveraging the Leadership Development Model (LDM) to help them reach their full potential. • Lead the identification and development of future leaders within the PSC ensuring a strong leadership pipeline for continued growth. • Ability to lead teams through operational challenges and unexpected disruptions as well as manage conflict resolution using de-escalating techniques to support team as well as client expectations. • Stakeholder & Cross-Functional Collaboration • Establish and maintain strong relationships with Regional Vice Presidents (RVPs) and their regional leadership teams to ensure health system and clinic satisfaction. • Serve as a trusted partner and subject matter expert to hospital and clinic leadership, helping resolve operational challenges and drive service excellence. • Partner with data analytics and other functional teams to evaluate performance metrics, execute improvement initiatives, and support data-driven decision-making. • Engage with hospital clinic leaders to proactively address barriers to medication adherence, prior authorizations, and high financial co-pays, developing innovative solutions to enhance patient support. • Stakeholder influence in a matrixed organization will be necessary to influence people without direct authority (particularly true when working with client partners and regional facing support teams) • Performance Management & Compliance • Ensure consistent adoption of best practices across all PSC operations, driving alignment with Shields Health Solutions' mission and values. • Create and track key performance indicators (KPIs) using data analytics to measure success, identify opportunities, and drive performance enhancements. (KPIs to include things such as refill adherence rates, productivity, Prior Authorization Turn Around Time, Financial Assistance completion rates, and similar types of key measures) • Maintain high accountability in balancing patient care, productivity, service levels, and operational targets. • Lead projects and sponsor initiatives that leverage technology and automation to optimize patient support operations. • Ensure compliance with HIPAA regulations and uphold ethical standards in handling patient information and company proprietary data. • Travel as necessary to support business operations and health system partner needs (estimated 20%-25%). • Other duties as assigned. • Education / Certifications: • Bachelor’s degree in Business Administration, Healthcare Administration, or a related field required. • Advanced degrees (e.g., MBA, MHA, or equivalent) preferred but not required. • PharmD or BS in Pharmacy is a plus but not required (state certification not necessary).