The Copay Services Leader will be responsible for overseeing the design, implementation, and day-to-day management of the company's copay assistance programs, both pharmacy and medical copay. This role ensures that patients receive financial assistance for their prescription medications, while also working closely with pharmaceutical clients to meet program goals. The leader will manage a team of professionals, ensuring operational excellence, compliance with all regulatory guidelines, and alignment with client expectations.
DUTIES & RESPONSIBILITIES:
Program Leadership & Strategy:
- Lead the development, implementation, and optimization of pharmacy and medical copay assistance programs to ensure patient access to medications
- Collaborate with internal teams (e.g., reimbursement, operations, account management) and external stakeholders to tailor copay programs to specific client needs
- Define and monitor key performance indicators (KPIs) to evaluate program success and identify areas for improvement
- Partner with senior leadership to refine overall strategy, ensuring programs align with company objectives and client goals
Team Management & Development:
- Lead and mentor a team of copay services specialists, ensuring high levels of engagement, productivity, and customer service
- Provide coaching, performance evaluations, and development opportunities to build team capability and expertise
- Oversee staffing and resource planning to ensure efficient program operations and scalability
Client & Stakeholder Engagement:
- Serve as the primary point of contact for pharmaceutical clients, addressing their program needs, performance updates, and operational feedback
- Participate in client meetings and presentations to provide insights and updates on copay program performance
- Establish and maintain relationships with pharmacy benefit managers (PBMs), specialty pharmacies, and other external partners to streamline copay processes
Compliance & Reporting:
- Ensure copay assistance programs comply with all federal, state, and industry regulations, including anti-kickback statutes, Medicare/Medicaid rules, FDA and OIG guidance
- Work closely with the legal and compliance teams to manage risk and adhere to industry best practices
- Oversee the generation and analysis of program performance reports, ensuring timely and accurate reporting to clients and internal stakeholders
Operations & Continuous Improvement:
- Streamline operational workflows to improve the efficiency of copay processes, from enrollment to claim adjudication and payment
- Identify and implement process improvements to enhance the patient experience and reduce administrative burdens
- Stay up to date on trends in pharmaceutical reimbursement, copay policies, and patient assistance programs to keep the company's offerings competitiv
- Education:
- Bachelor's degree in business, healthcare management, pharmacy, or a related field (required)
- Master's degree in business or healthcare administration (preferred)
Requirements
Education:
- Bachelor's degree in business, healthcare management, pharmacy, or a related field (required)
- Master's degree in business or healthcare administration (preferred)
Experience:
- 5+ years of experience in pharmacy copay assistance programs, reimbursement services, or patient access within the pharmaceutical or healthcare industries
- 5+ years of experience in medical copay assistance programs, reimbursement services, or patient access within the pharmaceutical or healthcare industries
- Proven leadership experience in managing teams and working cross-functionally
- Experience working with pharmaceutical manufacturers and understanding of third-party payer systems (commercial, Medicare, Medicaid)
Skills & Competencies:
- Strong leadership and team management abilities, with a track record of driving performance
- Excellent communication and client relationship management skills
- Thorough understanding of pharmaceutical copay structures - pharmacy and medical, including benefit design, reimbursement systems, and financial assistance programs
- Knowledge of regulatory requirements affecting pharmacy and medical copay programs, including healthcare compliance and fraud prevention
- Ability to analyze data and make informed decisions to optimize program performance
- Strong background working with various IT systems and tools to pull reports, analyze data and build insights and recommendations
Benefits
Want to learn more about what employee benefits AssistRx offers? Here are some additional benefits that our employees enjoy!
- Medical, dental, vision, life, & short-term disability insurance
- Teledoc services for those enrolled in medical insurance
- Supportive, progressive, fast-paced environment
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Legal insurance
Wondering how we recognize our employees for delivering best in class results? Here are some of the awards that our employees receive throughout the year!
- #TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis
- Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork
- Vision Award: This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy
AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.
All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.
AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.
