AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving health care outcomes for all! We promise to do what’s right, always.
Position Summary:
The Director, Patient Experience serves as the senior operational leader for the Patient Experience function, accountable for the development and execution of the operating strategy and for scalable, consistent, high-quality service delivery. This role leads assigned managers and operational teams and owns workforce and capacity planning, service performance, quality assurance, process governance, operational readiness, and continuous improvement. Working directly with executive leadership and cross-functional partners, the Director establishes priorities, makes operational decisions within delegated authority, and ensures measurable results that support the patient experience and organizational objectives.
What you will do:
Operational Leadership and Management:
- Set Patient Experience operational priorities and lead day-to-day execution across functions, aligning staffing, workflows, service standards, and departmental plans with company objectives
- Lead, coach, and develop assigned managers and operational leaders; establish clear expectations, accountability, succession planning, and consistent management practices
- Develop and execute the Patient Experience operating plan and roadmap, establishing priorities, accountable owners, timelines, performance measures, and regular executive-level reviews
- Make timely operational decisions; identify and mitigate service risks, direct corrective actions, and elevate material strategic, financial, or compliance matters to executive leadership
Workforce Planning, Capacity, and Operational Readiness:
- Own the Patient Experience workforce and capacity planning model, including demand forecasting, workload distribution, staffing needs, productivity assumptions, and coverage strategies
- Develop staffing, resource, and budget recommendations, including hiring priorities, training capacity, and deployment of resources to support growth, changing volume, and evolving patient and client needs; monitor productivity and costs against budget and recommend investments or adjustments to executive leadership
- Lead Patient Experience operational readiness for new client implementations, formulary changes, benefit transitions, and service model changes, including procedures, training, communication, and escalation pathways
- Coordinate internal teams and external service partners to maintain service continuity, effective handoffs, and clear accountability across workflows
Service Performance, Reporting, and Accountability:
- Establish and manage operational KPIs and performance routines, including service levels, turnaround time, productivity, case aging, resolution quality, patient satisfaction, and trend-based improvement actions
- Deliver consistent manager-level, departmental, and executive-ready reporting that communicates results, risks, root causes, corrective actions, and progress against commitments
- Use operational data, patient feedback, satisfaction results, and service trends to identify performance gaps, forecast emerging needs, and prioritize improvements to access, communication, navigation, and resolution outcomes
Quality Assurance, Process Governance, and Continuous Improvement:
- Oversee a standardized quality assurance and coaching framework across Patient Experience interactions and case documentation, partnering with designated quality and training resources
- Ensure operational procedures, knowledge resources, workflows, and escalation standards are documented, maintained, consistently applied, and aligned with applicable privacy and compliance requirements
- Drive root-cause analysis and corrective action for recurring patient issues, quality defects, operational inefficiencies, and service disruptions
- Champion cross-functional process improvements and change adoption, including measurement of results and ongoing controls
Cross-Functional Collaboration and Patient Experience:
- Partner with Client Management, Clinical, Implementations, IT, Compliance, and vendor teams to improve end-to-end patient and client service delivery
- Provide leadership oversight for complex or systemic escalations, ensuring timely resolution, clear ownership, and identification of broader operational improvements
- Represent and lead Patient Experience in executive and cross-functional reviews, enterprise planning, and initiatives requiring coordinated execution and organizational decisions
What you need:
- Bachelor’s degree in healthcare administration, business, operations, or a related field, or equivalent relevant experience; advanced degree or applicable professional certification preferred
- 10+ years of progressive leadership experience in healthcare operations, patient/member services, contact center operations, pharmacy benefits, insurance, or related settings, including experience managing managers or complex cross-functional operations
- Demonstrated ownership of operational performance, workforce or capacity planning, quality programs, reporting, and process improvement
- Strong understanding of pharmacy benefit management, benefit administration, patient navigation, and related operational processes preferred
- Ability to define operational KPIs, analyze trends, present executive-ready insights, and turn findings into practical action plans
- Excellent leadership, communication, judgment, and stakeholder management skills; ability to influence across teams and vendor relationships
- Experience with CRM/case management tools, reporting platforms, workforce management tools, and standard business productivity software
- Knowledge of applicable privacy, compliance, and service standards; commitment to confidentiality and ethical practices
- Ability to balance competing priorities, manage organizational change, and operate effectively in a fast-paced, growing environment
- Willingness to travel up to 10-20 % for meetings, training, and organizational needs
What you get:
- To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes
- To work in a culture where people thrive because when OUR team thrives, OUR business thrives
- Competitive compensation, including health, dental, vision and other benefits
Note:
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.
