Practice Group Manager overseeing support and operations in mental healthcare offices across Georgia. Ensuring clinical and financial objectives are met while cultivating team performance.
About the role
- 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
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