Field Reimbursement Manager at Johnson & Johnson responsible for HCP education and patient access in Immunology therapies. Managing relationships and support for healthcare providers in designated territories.
Responsibilities
Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and launch products.
Collaborate with field support team members such as sales representatives and key account managers and serve as reimbursement expert for the local team.
Act with a sense of urgency to address critical access and affordability issues for patients.
Partner with managed care colleagues to understand current policies and potential future changes.
Conduct field-based reimbursement and access support, education and creative problem-solving aligned to FRM Rules of Engagement.
Build strong, trust-based relationships with customers in all assigned Immunology accounts.
Manage territory logistics, routing, and account business planning.
Maintain and grow knowledge of national, regional, local, and account market dynamics including coverage and coding requirements.
Grow the knowledge of hub and specialty distribution channels to improve practice and patient support needs.
Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS.
Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training.
Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff
Requirements
Bachelor’s degree (preferably in healthcare or business/public administration).
An advanced business degree (MBA), or public health (MPH) is preferred.
Minimum of 5 years of relevant professional experience Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationships.
Demonstrated expertise with both pharmacy and medical/buy & bill benefits (as applicable), coding, and billing.
Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes)
Ability to establish relationships, collaborate, and influence across a matrix organization.
Problem-solving ability to navigate challenging access scenarios and identifies solutions in a timely and efficient manner.
Experience in working with patient support HUB services.
Valid US driver’s license and a driving record in compliance with company standards
Ability to consistently maintain up to 50% travel.
Permanent residence in the listed territory
Preferred Immunology disease state experience
Advanced degree and/or relevant certifications in prior authorization and/or billing and coding
Strong market access acumen as it relates to payer approval processes and business acumen.
Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
Excellent technical knowledge and expertise in payer policy, including all elements of reimbursement (coding, coverage, and payment) is preferred.
Demonstrated competence with salesforce.com CRM use, Microsoft Word, and Excel
Benefits
Subject to the terms of their respective plans, employees are eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).
This position is eligible to participate in the Company’s long-term incentive program.
Vacation –120 hours per calendar year
Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado –48 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year
Holiday pay, including Floating Holidays –13 days per calendar year
Work, Personal and Family Time - up to 40 hours per calendar year
Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child
Bereavement Leave – 240 hours for an immediate family member: 40 hours for an extended family member per calendar year
Caregiver Leave – 80 hours in a 52-week rolling period10 days
Volunteer Leave – 32 hours per calendar year
Military Spouse Time-Off – 80 hours per calendar year
Job title
Field Reimbursement Manager – Immunology, Dermatology
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