[Hiring] Director, Reimbursement Strategy & Patient Access Excellence @Helpware

Role Description

The Director of Reimbursement Strategy & Patient Access Excellence serves as a senior-level subject matter expert and strategic advisor responsible for advancing reimbursement expertise, patient access effectiveness, and operational excellence across specialty pharmaceutical reimbursement programs, with an initial emphasis on GLP-1 medications. This position requires an individual with Director-level industry experience who can combine strategic reimbursement knowledge with hands-on expertise in benefits investigations, prior authorizations, payer policy interpretation, appeals, coverage challenges, and patient financial assistance programs.

The Director will provide specialized guidance to Reimbursement Analysts, operational leadership, training, quality assurance, and client stakeholders to ensure complex reimbursement processes are managed accurately, efficiently, and in accordance with applicable regulatory and payer requirements.

Unlike a traditional departmental Director, this position emphasizes functional expertise, strategic advisory support, reimbursement excellence, and technical leadership rather than direct personnel management.

The successful candidate will be equally comfortable advising executive stakeholders, resolving complex reimbursement barriers, coaching frontline analysts, and supporting the development of scalable reimbursement operations.

Qualifications

• Bachelor's degree in healthcare administration, business, pharmacy-related studies, or a related discipline, or equivalent combination of education and directly relevant experience.
• 8–10+ years of progressive experience in pharmaceutical reimbursement, patient access, specialty pharmacy, healthcare revenue cycle, or related healthcare insurance operations.
• 3+ years of Director-level experience or equivalent senior functional leadership experience involving reimbursement strategy, complex escalation management, or cross-functional patient access initiatives.
• Advanced working knowledge of benefit investigations, prior authorizations, appeals, coverage determinations, payer policy interpretation, and reimbursement workflows.
• Demonstrated experience resolving complex pharmaceutical reimbursement and patient access challenges.
• Experience providing strategic advisory support to operational leaders, client stakeholders, or senior healthcare professionals.
• Demonstrated ability to translate technical reimbursement expertise into practical operational solutions.
• Experience coaching, mentoring, or providing technical direction to reimbursement professionals.
• Strong analytical, problem-solving, communication, and stakeholder management capabilities.
• Working knowledge of HIPAA, patient confidentiality, and applicable healthcare reimbursement compliance requirements.
• Ability and willingness to remain actively engaged in detailed reimbursement workflows while providing senior-level guidance.

Requirements

• Direct experience with GLP-1 therapies and payer requirements involving Type 2 diabetes and chronic weight management.
• Experience within pharmaceutical manufacturer patient support programs, specialty pharmacy services, patient access hubs, or reimbursement support organizations.
• Familiarity with commercial payer and government-program coverage policies.
• Experience supporting reimbursement operations in a business process outsourcing or third-party service environment.
• Experience supporting large-scale or rapidly expanding reimbursement teams.
• Familiarity with electronic prior authorization systems, payer portals, CRM platforms, and case management applications.
• Relevant pharmacy technician registration, professional certification, or specialized reimbursement credentials, where applicable.

Benefits

• Reimbursement Accuracy - Reduction in preventable processing and documentation errors.
• Technical Escalation Support - Timely resolution or appropriate routing of complex cases.
• Prior Authorization Effectiveness - Submission completeness and preventable error trends.
• Operational Improvement - Documented reductions in rework and recurring workflow issues.
• Knowledge Development - Improvements in analyst technical proficiency.
• Payer Policy Readiness - Timely identification and communication of applicable payer changes.
• Client Partnership - Responsiveness, technical accuracy, and effectiveness of advisory support.
• Program Scalability - Development and adoption of consistent, sustainable reimbursement practices.

Success Profile

The successful candidate will bring the strategic perspective of an experienced pharmaceutical reimbursement leader with the practical, hands-on expertise of an advanced Reimbursement Analyst SME. This individual will be recognized for the ability to resolve complicated reimbursement challenges, develop people through technical guidance, advise senior stakeholders, and improve operational performance without requiring traditional departmental management responsibilities. The ideal candidate is a seasoned reimbursement professional who enjoys applying senior-level expertise directly to solving complex patient access and operational challenges.