Johnson & Johnson

Field Reimbursement Manager – Rheumatology

Johnson & Johnson

full-time

Posted on:

Location Type: Hybrid

Location: Seattle • Washington • United States

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Salary

💰 $100,000 - $175,000 per year

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
  • 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

  • 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
  • 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
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
reimbursement processesclaims submissionscoding requirementsprior authorizationbuy & billrevenue cycleaccount managementpatient support HUB servicesmarket dynamicsmedication access channels
Soft Skills
collaborationrelationship buildingproblem-solvinginfluencecommunicationurgencytrust-buildingadaptabilitycreativityeducation
Certifications
Bachelor’s degreeMBAMPHvalid US driver’s license