Case Management Operations Director

Alivia Health, Llc

Puerto Rico
Permanent
Full-time

2 days ago

We are seeking a strategic leader to oversee and optimize Case Management operations within a specialty pharmacy setting. This role is responsible for ensuring timely patient access to therapy, enhancing patient experience, and driving operational excellence and regulatory compliance.Lead case management operations including prior authorizations, appeals, and coordination with providers, payers, and PBMs
Drive operational efficiency, reduce resolution times, and improve approval rates
Develop and lead high-performing, patient-focused teams
Strengthen partnerships with physicians, health plans, and key stakeholders
Implement process improvements, technology solutions, and KPI-driven strategiesKey Requirements:
? Bachelor's degree in healthcare, business, or related field (advanced degree preferred)
? 10+ years of experience in case management, patient access, or pharmacy operations
? 3–5 years of leadership experience
? Strong knowledge of payer processes, PBMs, and prior authorizationsIf you are passionate about leading with impact and improving patient outcomes, we encourage you to apply.***EEOC F/M/D/V***

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