Field Reimbursement Manager – Immunology, Rheumatology
Johnson & Johnson
full-time
Posted on:
Location Type: Office
Location: Toledo • Ohio • 🇺🇸 United States
Visit company websiteSalary
💰 $102,000 - $177,100 per year
Job Level
Mid-LevelSenior
About the role
- 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. Market Access Expertise: Extensive knowledge of medication access channels (i.e., pharmacy and medical benefits including buy & bill and/or assignment of benefit (AOB) across multiple sites of care
- 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
- REQUIRED 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
- 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.
- Subject to the terms of their respective policies and date of hire, employees are eligible for the following time off benefits:
- 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 period
- Volunteer Leave – 32 hours per calendar year
- Military Spouse Time-Off – 80 hours per calendar year
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
reimbursement processesclaims submissionscoding requirementsaccount managementrevenue cyclebuy-and-billprior authorizationcodingbillingpatient support HUB services
Soft skills
relationship buildingcollaborationinfluenceproblem-solvingcommunicationurgencytrust-buildingcreative problem-solvingadaptabilitycustomer relationship management
Certifications
Bachelor’s degreeMBAMPHvalid US driver’s license