Director of Patient Access

At Gifthealth, we're revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions and health services. Our mission is to provide a seamless, personalized, and efficient healthcare experience for all our customers. We're a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people's lives.

At Gifthealth, we're revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions and health services. Our mission is to provide a seamless, personalized, and efficient healthcare experience for all our customers. We're a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people's lives.

The Director of Patient Access owns and continuously strengthens the prior authorization operating system that stands between a written prescription and a patient starting therapy. Working lateral to the Director of Patient Experience, this leader owns a large, multi-tiered team, including the staff who work directly with manufacturer Field Reimbursement Manager (FRM) teams, and is accountable for reliable, timely, and accurate prior authorization performance across programs.

This role exists because every day a PA sits unresolved is a day a patient waits for medication they need now. The mandate is speed, accuracy, visibility, and relentless follow-through. The Director builds a management system in which leaders can see the work, manage exceptions, solve problems at the right level, and escape when broader authority or systemic change is required.

The Director builds a management system in which leaders can see the work, manage exceptions, solve problems at the right level, and escape when broader authority or systemic change is required.

• Own PA turnaround time (TAT) and queue health. Set and manage program-appropriate TAT and aging targets, monitor performance and outliers, and ensure corrective action when trends slip.
• Serve as the primary FRM point of contact and owner of the FRM partnership model. Build and maintain working relationships with Field Reimbursement Manager teams across manufacturer partners, with clear communication and escalation pathways that keep PA and appeals workflows aligned end to end.
• Troubleshoot high-priority and systemic PA issues in real time. Lead root-cause investigation on stalled, denied, or escalated PAs, including payer rejections, data mismatches, and missing documentation, and ensure the right operational owner drives resolution and preventive action.
• Own complex escalations and escalation standards. Coordinate high-visibility issues across Client Success, Pharmacy Operations, Quality, and manufacturer partners. Ensure recurring escalations trigger root-cause analysis and systemic fixes, not repeated workarounds.

• Review PA data and balanced performance metrics. Track approval and denial rates, TAT by program and payer, aging PAs, denial reason codes, and available quality or rework indicators, and turn trends into action, not just reporting.
• Maintain performance visibility. Partner with analytics and operations teams to ensure dashboards and management views provide timely visibility into queue health, exceptions, and performance risks so issues are caught early.
• Drive process improvement from current-state evidence. Validate how work actually moves through teams, systems, queues, and handoffs before redesigning. Use measurable pilots to reduce time-to-therapy and rework, then standardize and scale what works.
• Partner on workflow and automation improvements. Ensure automation improves reliability, exceptions remain visible, and clear human-rescue paths exist when standard workflows fail.

• Own a large, multi-tiered Patient Access team. Lead the full team responsible for prior authorization and FRM-facing work, including Team Leads/Supervisors, FRM Liaisons, and PA Specialists/Coordinators, with clear performance expectations tied to TAT, quality, operating reliability, and patient outcomes.
• Develop team leads and supervisors as operational owners. Set the standard for leaders who run day-to-day PA operations, manage queues, coach their teams, solve issues within defined decision rights, and escape with facts and a recommendation when broader authority is needed.
• Hire, coach, and manage ld…