Field Reimbursement Manager – Urology
Johnson & Johnson
full-time
Posted on:
Location Type: Hybrid
Location: Dallas • Louisiana • Texas • United States
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Tech Stack
About the role
- Educate HCPs on 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 Oncology 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
Requirements
- Bachelor’s degree (preferably in healthcare or business/public administration)
- Minimum of 5 years of relevant professional experience
- Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationship
- Demonstrated expertise with both pharmacy and medical/buy & bill benefits, 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
- Superior communication skills (written and verbal) and efficient follow-through
- 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, with occasional overnight stay
- Permanent residence in the listed territory
- Preferred Oncology 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
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
reimbursement processesclaims submissionscoding requirementspharmacy benefitsmedical benefitsbuy-and-billprior authorizationbillingappeals processesmarket access acumen
Soft Skills
relationship buildingcollaborationinfluenceproblem-solvingcommunication skillsfollow-throughurgencytrust-buildingcreative problem-solvingaccount management
Certifications
advanced degreecertifications in prior authorizationcertifications in billing and coding