Field Reimbursement Manager – Immunology, Rheumatology
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Job Description
Field Reimbursement Manager handling patient access strategies in Immunology Rheumatology. Collaborating with healthcare providers and internal teams to ensure patient support and education.
Responsibilities:
- 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)
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 relationships
- 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, and group legal insurance
- Company’s consolidated retirement plan (pension) and 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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