Field Reimbursement Manager – Neuroscience
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Job Description
Field Reimbursement Manager helping healthcare providers overcome reimbursement barriers for Johnson & Johnson neuroscience therapies. Managing Philadelphia territory relationships, education, access support, and payer issues.
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 onsite with healthcare providers and HCP staff
- Educate HCPs on reimbursement processes, claims submissions, procedures, and payer coding requirements
- Collaborate with sales representatives, key account managers, and other field support team members
- Serve as the local team’s 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
- Partner with managed care colleagues on current policies and potential future changes
- 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 national, regional, local, and account market dynamics, including coverage and coding requirements
- Grow knowledge of hub and specialty distribution channels
- Collaborate with internal J&J departments including marketing, sales, medical science, SCG, IBG, HCC, and PECS
- Serve as subject matter expert on access and affordability solutions across Medicare, Medicaid Managed Care, Commercial, and other payer types
- Complete business activities in accordance with ethical, legal, and compliance standards and required training
Requirements:
- Bachelor’s degree required, preferably in healthcare or business/public administration
- Minimum of 5 years of relevant professional experience
- Account Management and/or Reimbursement experience in a 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 assignment of benefit (AOB)
- Ability to analyze highly complex quantitative and qualitative data
- Critical thinking and intellectual curiosity
- Ability to remain current on and anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices
- Ability to adapt to the changing healthcare ecosystem and customize resourcing and messaging to HCPs and HCP staff
- Advanced business degree (MBA) or public health degree (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
- Salesforce.com CRM, Microsoft Word, and Excel experience preferred
- Willingness to learn emerging technologies such as AI
- Ability to travel up to 75% of the time
Benefits:
- Consolidated retirement plan (pension)
- Savings plan (401(k))
- Long-term incentive program
- Vacation – 120 hours per calendar year
- Sick time – 40 hours per calendar year; 48 hours for employees residing in Colorado; 56 hours for employees residing in Washington
- 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 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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