State Operations Coverage Specialist
Patient Funding Alternatives · United States · US
Utilization Review
Remote
Pharmacist
Dentist
Demand68
Career growth56
Healthcare fit74
Remote potential45
Salary band
USD 62k – 62k
5-year outlook
Likely moderate, stable compensation for payer/access operations roles, with upward movement into lead, supervisor, or Medicaid program specialist positions; exact salary should be confirmed with the employer.
Clinical license
Not required
Applicant reach
broad
Seniority
mid
Employment type
full-time
Date found
2026-10-30
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- Profession fit
- Pharmacist, Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying for clinicians who want a non-clinical payer/access operations role and can leverage prior authorization, Medicaid, pharmacy benefits, or revenue-cycle experience. Less compelling if you need a clearly remote role, a clinical license-required position, or a higher-level strategy/consulting title.
Who should apply
Nurses, pharmacists, allied health professionals, IMGs, and healthcare graduates with insurance verification, prior authorization, Medicaid/managed care, pharmacy benefits, or revenue-cycle exposure, especially those familiar with Pennsylvania Medicaid or HIPP.
CV angle
Frame clinical work as coverage navigation and patient access: prior authorizations, formulary/medication access, Medicaid/underserved-patient coordination, insurance verification, denied-claim/appeal support, and multidisciplinary follow-up. Quantify authorization turnaround, medication access wins, caseload, and coordination outcomes without claiming non-clinical titles you did not hold.
Skills to highlight
- Insurance verification
- Prior authorization
- Medicaid and managed care
- Coordination of benefits
- Pharmacy benefits and formularies
- Revenue cycle
- Patient advocacy
- Communication and case follow-up
Role summary
Supports a Pennsylvania operations team by verifying network coverage, resolving coordination-of-benefits and pharmacy access issues, helping families obtain prior authorizations and medications, and maintaining Medicaid/HIPP knowledge.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.