Senior Manager, Copay and Affordability Programs

The Senior Manager, Copay and Affordability programs is responsible for end-to-end strategy, operations, and compliance for copay assistance and electronic prior authorization (ePA) programs. This role serves as the organizational copay and ePA subject matter expert (SME), managing vendor relationships and contracts, overseeing program performance and audits, and partnering across cross-functional teams to ensure patients can access therapy efficiently and compliantly.

You will be responsible for:

• Program Ownership (Copay): Lead day-to-day operations of the copay assistance program, ensuring seamless patient and HCP experience, operational reliability, and adherence to all applicable laws, regulations, and internal policies.
• Vendor Management (Copay & ePA): Manage copay and ePA vendors, including contract lifecycle, SOWs, KPIs/SLAs, QBR cadences, and performance remediation plans; drive continuous improvement and innovation.
• Compliance & Controls: Maintain compliant program design and execution, partnering with Legal, Compliance, Privacy, and Audit; develop and enforce SOPs, monitoring plans, and issue management with timely CAPAs as needed.
• Program Strategy & Optimization: Analyze utilization, affordability, and access trends; propose and implement strategies to improve patient activation, persistence, and cost-effectiveness while mitigating risk.
• Audit & Monitoring: Plan and execute internal/external audits of copay and ePA programs; oversee sampling, documentation, findings, corrective actions, and sustainability checks.
• Financial Stewardship: Own budget planning and management for copay and ePA, including forecasting, accruals, invoice review/approval, reconciliation, and vendor billing accuracy; track ROI and unit economics.
• Operational Analytics: Define and monitor dashboards and reports for KPIs (e.g., enrollment, claims, activation rates, time-to-therapy, approval rates, patient discontinuations due to affordability, fraud indicators); translate insights into actions.
• Stakeholder Engagement: Act as the copay and ePA SME; respond to inquiries from internal partners (Market Access, Commercial, Patient Services, Compliance, Finance, IT) and escalate/resolve as needed.
• ePA Program Management: Oversee ePA vendor operations, payer connectivity, coverage rules, and performance; ensure alignment with hub workflow, field teams, and patient journey.
• Cross-Functional Support: Provide backup support to the broader access team, including reimbursement hub operations, case management processes, and issue triage for patient support services.
• Risk Management: Identify operational, financial, and compliance risks; lead mitigation strategies, contingency planning, and incident response for program interruptions or data issues.
• Documentation & Training: Maintain program documentation, business rules, and change logs; deliver training and communications for field teams, hubs, and internal stakeholders.

You will need to have:

• Bachelor’s degree in Life Sciences or relevant field
• 7+ years in pharmaceutical patient support programs, market access, or specialty pharmacy/hub operations, with 4+ years directly managing copay/ePA programs and vendors.

Technical/Functional Skills:

• Deep knowledge of copay program design, claims processing, accumulator/ maximizer dynamics, OIG guidance, and industry compliance expectations.
• Working knowledge of ePA workflows, payer connectivity, NCPDP standards, and integration with hubs/EMR/eRx platforms.
• Proficiency with program analytics (Excel/BI tools), KPI dashboards, and financial management (budgeting, forecasting, invoicing).
• Experience drafting and managing contracts, SOWs, SLAs, and governance structures.

Competencies:

• Compliance mindset with strong judgment and attention to detail.
• Vendor leadership and negotiation skills; ability to hold partners accountable.
• Problem solving and optimization using data-driven insights.
• Stakeholder management and clear communication across cross-functional teams.
• Project management with the ability to manage multiple priorities and deadlines.