Field Reimbursement Manager educating and assisting healthcare providers for J&J Immunology therapies. Managing reimbursement processes and patient access within the assigned territory.
Responsibilities
Serve as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies.
Invest time (up to 50%) on-site with HCPs, assessing their education needs and facilitating collaboration with various stakeholders.
Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations.
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.
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.
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 relationship.
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.
Benefits
medical
dental
vision
life insurance
short- and long-term disability
business accident insurance
group legal insurance
consolidated retirement plan (pension)
savings plan (401(k))
vacation –120 hours per calendar year
sick time - 40 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
condolence leave – 30 days for an immediate family member: 5 days for an extended family member
caregiver leave – 10 days
volunteer leave – 4 days
military spouse time-off – 80 hours
Job title
Field Reimbursement Manager – Immunology, Rheumatology
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