Field Reimbursement Manager, Neuroscience – Patient Engagement & Customer Solutions
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Job Description
Field Reimbursement Manager supporting provider reimbursement and patient access to Johnson & Johnson neuroscience therapies. Managing a Denver-area territory spanning Colorado and Nebraska.
Responsibilities:
- Serve as the primary field-based lead for education, assistance, and issue resolution regarding patient access to J&J Neuroscience therapies
- Spend up to 50% of time on-site with healthcare providers and provider staff
- Educate healthcare providers on reimbursement processes, claims submissions, procedures, and payer coding requirements
- Collaborate with sales representatives, key account managers, managed care colleagues, and internal J&J departments
- Serve as the local access, fulfillment, and reimbursement expert
- Lead compliant access and fulfillment discussions
- Use data and account management skills to proactively address access barriers
- Address critical patient access and affordability issues with urgency and accountability
- Conduct field-based reimbursement and access support, education, and creative problem-solving
- Build trust-based relationships with customers in assigned accounts
- Manage territory logistics, routing, and account business planning
- Maintain knowledge of market dynamics, coverage, and coding requirements
- Develop knowledge of hub and specialty distribution channels
- Serve as subject matter expert on access and affordability solutions across Medicare, Medicaid Managed Care, and commercial payer plans
- Execute business according to ethical, legal, and compliance standards and complete 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
- Expertise with pharmacy and medical/buy & bill benefit design, coding, billing, prior authorizations, office operations, and appeals processes
- Reimbursement or relevant managed care experience, including 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 identify timely, efficient solutions
- Superior written and verbal communication skills and efficient follow-through
- Experience working with patient support HUB services
- Valid US driver’s license and driving record compliant with company standards
- Permanent residence in the listed territory
- Extensive knowledge of medication access channels, including pharmacy and medical benefits, buy & bill, and/or assignment of benefit
- Ability to analyze highly complex quantitative and qualitative data
- Bachelor’s degree in healthcare or business/public administration preferred; MBA or MPH preferred
- Neuroscience disease state experience preferred
- Advanced degree and/or relevant certifications in prior authorization and/or billing and coding preferred
- Knowledge of Medicare, Medicaid, and private payer initiatives affecting pharmaceutical and biotechnology reimbursement preferred
- Technical expertise in payer policy, coding, coverage, and payment preferred
- Salesforce.com CRM, Microsoft Word, and Excel proficiency preferred
- Travel up to 75% of the time
Benefits:
- Long-term incentive program eligibility
- Vacation – 120 hours per calendar year
- Sick time – 40 hours per calendar year; Colorado residents – 48 hours per calendar year; Washington residents – 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
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