Field Reimbursement Manager, Urology
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Job Description
Field Reimbursement Manager for Johnson & Johnson supporting patient access to Oncology therapies. Responsible for educating healthcare providers and managing reimbursement processes.
Responsibilities:
- Educate HCPs on 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 Oncology 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:
- Required 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, with occasional overnight stay.
- Permanent residence in the listed territory.
- Preferred Oncology disease state experience.
- Advanced degree and/or relevant certifications in prior authorization and/or billing and coding.
- Strong market access acumen as it relates to payer approval processes and business acumen.
- Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
- Excellent technical knowledge and expertise in payer policy, including all elements of reimbursement (coding, coverage, and payment) is preferred.
- Demonstrated competence with salesforce.com CRM use, Microsoft Word, and Excel.
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 period.10 days.
- Volunteer Leave – 32 hours per calendar year.
- Military Spouse Time-Off – 80 hours per calendar year.
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