OneTrust

Field Reimbursement Manager – Immunology, GI

OneTrust

full-time

Posted on:

Location Type: Hybrid

Location: Princeton • New Jersey • 🇺🇸 United States

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Salary

💰 $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.

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 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.
  • 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 period10 days 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 requirementspharmacy benefitsmedical benefitsbuy-and-billprior authorizationappeals processesaccount managementrevenue cycle
Soft skills
relationship buildingcollaborationinfluenceproblem-solvingcommunicationurgencytrust-buildingcreative problem-solvingefficient follow-throughcustomer relationship management
Certifications
Bachelor’s degreeMBAMPHvalid US driver’s license