Director, Patient Access & Case Management

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8®, for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in the United States, Australia, the United Kingdom, and Germany.

The Role:

The Director, Patient Access & Nurse Case Management is responsible for leading a team of Nurse Case Managers and Prior Authorization Specalists and is accountable for the end-to-end progression of patients from initial identification through implant. This role sits at the critical intersection of patient care, operational efficiency, and commercial execution.

This leader is expected to balance a compassionate, patient-first mindset with commercial urgency and accountability, ensuring patients do not stall in the funnel due to avoidable barriers, passive coordination, or lack of follow-through. The Director will actively ensure patients’ progress through the funnel by navigating past avoidable barriers, and elevating team performance to the highest standards supporting coordination and ensuring follow up. 

Position Responsibilities: 

Team Leadership & Operations

• Hire, lead, mentor, and develop Nurse Case Managers, fostering a culture of empathy, accountability, urgency, and operational excellence.
• Develop, establish and enforce clear standards for productivity, responsiveness, documentation quality, and case progression.
• Oversee workload distribution, pipeline progression, and performance metrics.
• Establish and reinforce consistent pipeline management workflows and operating processes across Case Management, Therapy Managers and field-based roles.
• Conduct regular 1:1s, team meetings, and structured case reviews with the goal of developing and cultivating talent.
• Build standardized onboarding, training, and performance management frameworks.
• Champion consistent use of cloud-based documentation systems.

Performance & Accountability Leadership

• Coach Nurse Case Managers & Prior Authorization teammates toward ownership of outcomes and problem-solving.
• Remediate performance gaps through coaching and corrective action.
• Drive performance accountability acrross the team to defined KPIs.

Clinical & Case Management Oversight

• Serve as a subject matter expert in ReActiv8® therapy and protocols.
• Ensure high-quality, compliant patient documentation.
• Guide insurance navigation, prior authorizations, and appeals.
• Establish best practices for patient interactions and documentation.

Cross-Functional Collaboration

• Partner closely with Sales, Reimbursement (REMA), Marketing, Legal, and healthcare providers across an assortment of payer & patient strategies.
• Serve as a trusted partner and collaborator to Field-Sales. 
• Attend, audit and support pipeline calls.
• Act as an escalation point for complex cases.

Patient Experience & Compliance

• Champion a compassionate, patient-first experience.
• Ensure compliance with Mainstay Medical requirements.
• Monitor documentation quality and timeliness.

Additional Responsibilities

• Flexibility to support field-team time zones as business dictates.

Qualifications:

• 10 years of experience across patient-support functions such as case management, care coordination, or prior authorization with a proven track record of effective partnership with field-based sales teams.
• 5 years of people-management experience, ideally in a healthcare or medical device environment.
• Experience identifying, planning and leading performance improvement initiatives.
• Strong understanding of insurance processes, including Medicare, Medicaid, and commercial payers policies.
• Demonstrated experience reviewing medical documentation, conducting clinical assessments, and guiding patient decision pathways.
• Experience with software and tools useful in achieving productivity gains in prior authorization and case management processes
• Skilled in-patient education and empathetic communication.
• Comfortable presenting to both small and large groups.
• Strong written and verbal communication skills across patients, clinicians, and internal teams.
• Ability to balance clinical judgment with business outcomes.
• Proficiency with Microsoft Office and cloud-based documentation systems (SFDC, Sugar, NetSuite, SAP, Hubspot, other); ability to ensure team-wide adoption and consistency.
• Strong analytical thinking, problem solving, and ability to interpret workflow data/KPIs.
• Strategic thinker, demonstrated experience developing and executing a plan for Case Management excellence.

The salary range for this position is $175,000 to $220,000/year; however, base pay offered will take into account a range of factors, including job-related knowledge, skills, and experience. The total compensation package includes a range of medical, dental, vision, financial, and other benefits, as well as equity.