Full-Time

Field Reimbursement Manager

Posted on 5/12/2025

CoverMyMeds

CoverMyMeds

1,001-5,000 employees

Streamlines medication access through technology

Compensation Overview

$88.3k - $147.1k/yr

+ Annual Bonus + Long-term Incentive Opportunities

Mid, Senior

New York, NY, USA

Must reside in territory (New York).

Category
Customer Success
Sales & Account Management
Required Skills
PowerPoint/Keynote/Slides
Requirements
  • 4-year degree in related field or equivalent experience
  • 4+ years of healthcare related reimbursement experience
  • Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
  • Must have Medicare and commercial insurance coverage experience
  • Proven presentation skills and experience
  • Proven ability to effectively handle multiple priorities and excellent organizational skills
  • Strong Computer literacy to include PowerPoint and Web Meeting experience
Responsibilities
  • Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available.
  • Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams.
  • Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs.
  • Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework.
  • Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
  • Research and compile provider / manufacturer representative specific information for reimbursement database.
Desired Qualifications
  • Previous field experience, a plus
  • Previous experience with specialty pharmacy a plus
  • Account management experience, a plus
  • Excellent Interpersonal skills.
  • Excellent written and oral communication skills
  • Problem solving and decision-making skills

CoverMyMeds focuses on improving medication access for patients by simplifying the prior authorization process, which is often a hurdle in receiving prescribed medications. The company provides a platform that connects healthcare providers, pharmacies, pharmacy benefit managers, and health plans, ensuring that patients can obtain their medications quickly and efficiently. This integration helps to enhance health outcomes by reducing delays in medication access. Unlike many competitors, CoverMyMeds emphasizes partnerships with various healthcare stakeholders to create administrative efficiencies and lessen the burden on healthcare systems. The company's goal is to make medication access easier for patients while maintaining high standards of privacy and security for patient information.

Company Size

1,001-5,000

Company Stage

Acquired

Total Funding

$1.1B

Headquarters

Twinsburg, Ohio

Founded

2008

Simplify Jobs

Simplify's Take

What believers are saying

  • AI integration enhances efficiency in prior authorization, aligning with CoverMyMeds' mission.
  • Digital therapeutics offer new integration opportunities, potentially improving patient outcomes.
  • Focus on interoperability drives demand for CoverMyMeds' seamless integration capabilities.

What critics are saying

  • Integration of RxLightning and FastAuth may disrupt operations and client relationships.
  • Layoffs and office closures could decrease morale and productivity, affecting service delivery.
  • Partnership with Fortuity Calling may divert resources from core business operations.

What makes CoverMyMeds unique

  • CoverMyMeds simplifies prior authorization, enhancing medication access for patients.
  • The company integrates with diverse healthcare stakeholders, improving interoperability and patient outcomes.
  • Recent acquisitions of RxLightning and FastAuth enhance patient support and authorization automation.

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Benefits

Remote Work Options

Flexible Work Hours

Professional Development Budget

Growth & Insights and Company News

Headcount

6 month growth

↑ 0%

1 year growth

↑ 0%

2 year growth

↑ 0%
CoverMyMeds
Jun 11th, 2025
CoverMyMeds adds new capabilities with acquisition of RxLightning and FastAuth

RxLightning, now a part of CoverMyMeds, transforms how patients enroll in Patient Support Programs, while FastAuth brings automation and intelligence to CoverMyMeds’ medical prior authorizations.

PRWeb
Jun 5th, 2024
Ncpdp Foundation Names Covermymeds As Fourth Founder'S Gift Donor

Gift will support research projects for the Coordination of Care and Innovation strategic initiativeSCOTTSDALE, Ariz., June 5, 2024 /PRNewswire-PRWeb/ -- The NCPDP Foundation announced today a new partnership with CoverMyMeds to support the Foundation's recently established fourth strategic initiative, which focuses on empowering Coordination of Care and Innovation."The NCPDP Foundation Board felt very strongly that our fourth strategic initiative should reflect the healthcare industry's shift to a team-based care model," said J.W. Hill, MBAHCM, CNED, Executive Director of the NCPDP Foundation. "From pharmacies and physicians to benefits managers and standards-makers like NCPDP, the need is recognized."A more interoperable approach to patient care—the heart of our Coordination of Care and Innovation initiative—is exactly the type of change needed to achieve the Foundation's vision of a healthcare ecosystem that continuously innovates and fully incorporates health information technology as a tool to deliver better outcomes for the common good of all," Hill concluded.While much progress has been made to streamline electronic documentation and information exchange in the last decade, there are still many underexplored opportunities to prove how pharmacists contribute to a patient-centered care model. Innovations that are on the horizon in digital therapeutics and pharmacogenomics will put even more emphasis on everything pharmacists do for patients outside of dispensing. The Founder's Gift for the Coordination of Care and Innovation initiative will support projects that show how pharmacists can close gaps in care."As a leader in breaking down barriers to medication access and affordability, CoverMyMeds understands the importance of collaboration and interoperability in delivering better patient outcomes," said Kristina Crockett, Vice President, Product, CoverMyMeds. "Our investment in research efforts that align with the NCPDP Foundation's Coordination of Care and Innovation initiative reflects our ongoing commitment to helping people get the medicine they need to live healthier lives

Business Wire
Apr 25th, 2024
Ontada Names Jade Cusick Chief Commercial Officer

BOSTON--(BUSINESS WIRE)--Ontada®, a McKesson business dedicated to leveraging oncology real-world data and evidence, clinical education, and provider technology, announced the appointment of Jade Cusick as its new Chief Commercial Officer and member of the Ontada leadership team. In this role, Cusick will focus on spearheading client partnerships, commercialization, and growth initiatives, along with marketing activities across key customer segments and stakeholders. “With over two decades of experience in the life sciences industry, we are thrilled to welcome Jade to our team,” said Christine Davis, President, Ontada. “Jade brings a deep understanding of the importance of creating consistent quality, delivery, and customer engagement processes for our custom and product data offerings for our customers.”. In his most recent role, Cusick held the role of Chief Commercial Officer at Aetion. Prior to that, he held the Chief Commercial Officer role and served on the executive committee of Cerner Enviza, an Oracle company, where he led client partnerships and commercialization efforts

Business Wire
Feb 8th, 2024
Mckesson’S Practice Insights Designated As A 2024 Qualified Clinical Data Registry By Centers For Medicare Medicaid Services

IRVING, Texas--(BUSINESS WIRE)--For the eighth consecutive year, McKesson has received approval from the Centers for Medicare Medicaid Services (CMS) to participate in the Merit-based Incentive Payment System (MIPS) as a Qualified Clinical Data Registry (QCDR). The designation enables healthcare practices and providers utilizing iKnowMed℠ electronic health record (EHR) to efficiently submit data directly to CMS without engaging a separate registry vendor, streamlining data submission and minimizing administrative burden. As a CMS-approved QCDR, Practice Insights℠, a performance analytics tool powered by Ontada®, can collect and report clinical data on behalf of clinicians for standard MIPS measures. This designation also provides the additional ability to report on custom QCDR quality measures developed in partnership with physicians in The US Oncology Network (The Network) to drive improvements in quality and cost of care. In addition to quality measures, practices now have the opportunity to improve patient care by identifying social drivers of health via the integration of the National Comprehensive Cancer Network (NCCN) Distress Thermometer in iKnowMed. In 2024, care teams can monitor patient needs through a comprehensive report dashboard and track screening rates based on the new MIPS 487 Screening for Social Drivers of Health measure

PRWeb
Oct 25th, 2023
Ncpdp Explores Future Of Pharmacy Practice At Its 2023 Virtual Educational Summit "Power To The Pharmacist: Expanding The Role Of Medication Experts To Improve Care"

Virtual Event takes place November 14 and 15. Register by Friday, November 3rd to Lock in Early Bird Savings.SCOTTSDALE, Ariz., Oct. 25, 2023 /PRNewswire-PRWeb/ -- NCPDP announced its 2023 Educational Summit, "Power to the Pharmacist: Expanding the Role of Medication Experts to Improve Care", a virtual event to be held from 11 a.m. – 3:00 p.m. ET on November 14 and 15, 2023. The event is exclusively focused on efforts that will enable pharmacists to operate at the top of their licensure, collaborating with other healthcare providers, to close gaps in care, improve care coordination, increase health equity, and improve health outcomes

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