Copay Manager - Support Program/Claims Processing

The Copay Support Program Manager is a critical role within the organization and is primarily responsible for the creation, design, set-up and administration of Pharmacy and Medical Copay programs for AssistRx manufacturer clients. Required engagement with client, account managers, program managers, finance team members and other departments within the organization to implement and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day operations and provide ongoing Copay program metrics for internal and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances as well as replenishment needs. This position will identify and report Copay trends, patterns and behaviors as well as make recommendations to increase utilization based on Copay claims and patient compliance/adherence activities. Also, this position will implement data-driven initiatives to achieve operational and process excellence that will optimize and increase the number of Copay Programs supported and managed by AssistRx. 

Program Strategy & Execution

• Serve as the primary client contact for the development, implementation, and ongoing management of pharmaceutical copay programs.
• Lead the design and administration of program business rules and ensure successful integration with adjudication systems.
• Oversee daily operations of assigned copay programs, ensuring service level excellence and compliance with contractual obligations.

Stakeholder Collaboration

• Partner cross-functionally with internal departments (Account Management, Program Management, Finance, IT) and external partners (vendors, adjudicators, pharmacies, sites of care) to ensure program success.
• Collaborate with clients on program enhancements, process improvements, and performance initiatives to maximize program utilization and outcomes.

Operational Excellence

• Direct the day-to-day activities of the copay team, including training, coaching, and mentoring team members on program operations and adjudication troubleshooting.
• Ensure effective quality control and accuracy in program set-up, updates, and reporting deliverables.
• Manage program performance through KPIs, metrics reporting, and operational reviews.

Data Analysis & Financial Oversight

• Analyze claims data to monitor copay program utilization, identify trends, and forecast program needs (escrow balances, replenishments).
• Provide actionable insights and recommendations to improve patient engagement and program adherence.
• Partner with finance to support billing processes, escrow account reconciliation, and financial reporting.

Client Engagement & Communication

• Build and maintain strong client relationships through proactive communication, trust-building, and delivering results.
• Present program metrics, performance trends, and recommendations during client meetings and business reviews.
• Act as a Subject Matter Expert on all matters related to copay and affordability programs within AssistRx.

• Proven experience managing pharmacy or medical copay programs within a healthcare, pharma services, or HUB services environment.
• Strong understanding of claims adjudication processes, reimbursement models, and affordability solutions.
• Skilled in program design, implementation, and operational management.
• Advanced proficiency in data analysis and reporting with the ability to interpret and communicate business impacts.
• Excellent communication, client relationship management, and cross-functional collaboration skills.
• Leadership experience with a demonstrated ability to train, coach, and develop team members.
• Strong organizational skills with a focus on process improvement and operational excellence.

• Experience working with adjudication platforms, HUB services, and pharmaceutical manufacturer programs.
• Familiarity with patient assistance programs, specialty pharmacy operations, and healthcare compliance standards.

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

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.