Director, Patient Services - Reimbursement & Nursing

Job Title

Director, Patient Services - Reimbursement & Nursing

Requisition

JR000015026 Director, Patient Services - Reimbursement & Nursing (Open)

Location

Bridgewater, NJ

Additional Locations

Job Description Summary

Job Description

The Director, Patient Services – Reimbursement & Nursing Services is responsible for the day-to-day oversight of HUB operations, nursing programs, and third-party vendor partnerships that support patient onboarding and long-term adherence. This role includes developing, maintaining, and monitoring patient access programs, ensuring compliance with vendor contract requirements, and updating SOPs and policies as needed. The ideal candidate will have direct experience managing multiple patient services programs, including reimbursement HUBs and nursing services, and a demonstrated ability to drive performance through cross-functional partners and external vendors.

Principal Responsibilities

• Provide day-to-day vendor management of the reimbursement HUB and Nursing Programs 

• Continuously identify opportunities to enhance existing processes and programs or develop new initiatives that support patient access and adherence to specialty medications—through strategic planning, stakeholder alignment, leadership approval, and seamless implementation in partnership with internal teams and external vendors.

• Ensure seamless patient experience across all stages of support, including affordability assistance, product access through specialty pharmacies or free goods programs, and clinical education on proper product use and administration.

• Ensure adherence to SOPs, policies and call guides; Serve as the primary point of contact for vendors for daily escalation management and third-party auditing

• Oversee vendor training requirements for patient services programs to ensure training is aligned with program requirements, timely execution, and have a continual development program in place 

• Review and monitor daily performance of patient reimbursement and nursing programs and work with vendors to address fluctuations in service levels and KPIs to hold them accountable to contractual requirements

• Identify trends for ongoing program challenges and escalations, as well as best practices and work with leadership and cross functional teams to communicate impacts of the program to other key stakeholders

• Work with internal teams to ensure alignment of processes and awareness and understanding of the patient services programs, including program changes with key partners including, but not limited to: Reimbursement Customer Service Team, Specialty Pharmacy Team, Access Reimbursement Managers, ISS leadership, Legal and Compliance, Marketing, and Market Access Team

• Responsible for writing, maintaining and seeking approval on all Patient Service Programs - Reimbursement and Nursing Standard Operating Procedures, Job Aides, etc.

• Assess and monitor Nurse Programs and adherence to defined and documented process including frequent collaboration on process changes and opportunities with Marketing and Patient Services colleagues and through call monitoring and organizing/overseeing third party audits.

• Coordinates communication and fosters a collaborative team approach between hub and Nurse Team to ensure optimized communication and partnership to best support patients.

• Collaborate with HUB team to address identified process gaps or weaknesses 

Minimum Requirements

• Bachelor’s degree or equivalent relevant experience

• 12+ years of experience in specialty pharmaceutical reimbursement, ideally with a specialty pharmacy, biotech/specialty pharmaceutical manufacturer, or payer

• 3+ years of direct experience managing both Reimbursement and Nursing Patient Services Programs

• Strong written and verbal communication skills, with the ability to provide constructive feedback and clearly convey information tailored to diverse audiences

• Proven expertise navigating complex patient access and affordability challenges

• Solid understanding of Nurse Program compliance and regulatory standards

• Strong problem-solving skills, with the ability to apply analytical insights to drive effective solutions

• Highly organized and detail-oriented, capable of independently managing multiple priorities and deadlines; project management experience is preferred

• In-depth knowledge of benefit designs, payer operations, prior authori