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Coverage Determination Jobs Near Me

Experience in benefits verification, coverage determination, and reimbursement analysis for specialty medications (Required) * Experience with complex manufacturer‑restricted access models ...

Nurse Practitioner

Columbus, OH · On-site

$48.78 - $60.98/hr

Utilize Local Coverage Determination (LCD) criteria to support hospice eligibility and recertification. * Document clinical findings accurately and attest F2F encounters in the medical record in ...

Utilize Local Coverage Determination (LCD) criteria to support hospice eligibility and recertification. * Document clinical findings accurately and attest F2F encounters in the medical record in ...

Hospice Nurse Practitioner

Columbus, OH · On-site

$48.78 - $60.98/hr

Utilize Local Coverage Determination (LCD) criteria to support hospice eligibility and recertification. * Document clinical findings accurately and attest F2F encounters in the medical record in ...

Utilize Local Coverage Determination (LCD) criteria to support hospice eligibility and recertification. * Document clinical findings accurately and attest F2F encounters in the medical record in ...

Nurse Practitioner

Columbus, OH · On-site

$48.78 - $60.98/hr

Utilize Local Coverage Determination (LCD) criteria to support hospice eligibility and recertification. * Document clinical findings accurately and attest F2F encounters in the medical record in ...

... coverage options * Christmas bonus opportunity * Other bonus opportunities What You Bring We're looking for an Engineering Manager with the proactivity , determination , and commitment to excel in a ...

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Coverage Determination information

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$54.5K

$96.2K

$139K

How much do coverage determination jobs pay per year?

As of Aug 18, 2026, the average yearly pay for coverage determination in the United States is $96,169.00, according to ZipRecruiter salary data. Most workers in this role earn between $81,000.00 and $109,500.00 per year, depending on experience, location, and employer.
A map of the United States highlighting the number of Coverage Determination job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Coverage Determination job openings in each state, with California having the most at 2 and Hawaii the least at 0.

Vice President - Patient Access

Jobtailor

Columbus, OH • On-site

$150 - $210/hr

Other

Posted 13 days ago


Job description

Responsibilities
  • Leads the full lifecycle of prior authorization (PA) activities across all programs, including submissions, follow-ups, appeals, and exception handling.
  • Designs, documents, and operationalizes repeatable, high-quality PA and reimbursement models that can be consistently deployed across existing and new programs.
  • Oversees denial management and appeals strategy, ensuring effective resolution of access barriers while analyzing trends for improvements.
  • Partners with product and engineering teams to implement ePA tools and workflow automation.
  • Manages bridge, copay, and patient assistance programs to ensure rapid enrollment of eligible patients.
  • Owns prescriber office engagement, ensuring consistent communication and program launches.
Requirements
  • Bachelor’s degree in business administration, operations management, or related field (Required)
  • 15+ years of experience in specialty pharmacy patient access, hub services, or reimbursement operations (Required)
  • 5+ years in a senior leadership role with direct management of PA and reimbursement teams (Required)
  • Experience managing prior authorization operations across multiple payer types and therapeutic areas (Required)
  • Experience in benefits verification, coverage determination, and reimbursement analysis for specialty medications (Required)
  • Experience with complex manufacturer‑restricted access models (Preferred)
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