Director, Drug Authorization

This is an exempt on-site role, located at our New Providence CBO location. Compensation Range: $130,000.00 - $200,000.00/Annual (Dependent on Experience) The Director, Drug Authorization is a senior leadership role responsible for the end-to-end strategy, performance, and scalability of drug authorization operations across a growing national network of retina and general ophthalmology practices. This role owns the authorization lifecycle-from benefits investigation through payer approval, denial mitigation, and post- approval optimization-to ensure timely patient access to therapy while supporting enterprise financial and operational objectives. The Director plays a vital role in developing and executing enterprise drug mix and Gross Profit per Injection (GPPI) strategies in close partnership with Supply Chain, Finance, RCM, and Clinical leadership, while leading a centralized authorization organization, deploying automation, and standardizing processes across acquisitions. Role and Responsibilities: * Lead and execute enterprise drug authorization strategy across retina and ophthalmology service lines to ensure timely access to therapy and consistent payer compliance. * Oversee a fully centralized Drug Authorization organization, including benefits investigation, prior authorizations, treatment eligibility documentation, denial management, and appeals. * Partner with Supply Chain, Finance, RCM, and Clinical leadership to support development and execution of enterprise drug mix and GPPI strategies through authorization feasibility, payer policy insight, and operational execution. * Design and scale standardized authorization workflows that reduce cycle time, mitigate treatment delays, and support rapid growth in injection volume and practice footprint. * Develop and monitor enterprise KPIs including authorization turnaround time, pending and expiring authorizations, denial rates, payer-specific trends, and authorization-related revenue leakage. * Lead evaluation and deployment of automation and AI-enabled tools to improve authorization throughput, accuracy, auditability, and cost efficiency. * Serve as executive escalation point for complex payer issues, high-risk denials, and systemic authorization failures impacting patient care or revenue. * Lead authorization strategy and execution for new practice acquisitions and de novo expansions, ensuring rapid integration into centralized workflows with minimal disruption. * Establish quality assurance, compliance controls, and governance frameworks across all authorization processes. * Manage vendor, payer, and third-party relationships related to authorization services, technology platforms, and reimbursement policy. * Hire, develop, and mentor a high-performing leadership team; establish productivity benchmarks, performance standards, and career pathways. * Provide regular executive reporting and insights on authorization performance, operational risk, and financial impact. Essential Qualifications: Education: Bachelor's degree in Business, Finance, Healthcare Administration, or related field required. Advanced degree (MBA, MHA) preferred. Experience: 8-10+ years of progressive leadership experience in Revenue Cycle, Drug Authorization, or specialty pharmaceutical operations within a multi-site physician practice or healthcare services platform. Retina or ophthalmology experience strongly preferred. Knowledge / Skills / Experience: * Deep expertise in high-cost injectable drug authorization, payer policy interpretation, and reimbursement dynamics. * Demonstrated ability to scale centralized authorization operations across a growing national provider network. * Strong understanding of how authorization performance influences drug utilization, revenue integrity, and margin. * Experience deploying automation, analytics, and EMR/PMS-integrated workflows (Athena preferred). * Advanced data analysis, reporting, and executive communication skills. * Proven leadership, change management, and cross-functional collaboration capabilities. * Ability to balance patient access, clinical urgency, financial stewardship, and regulatory compliance.

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