Field Reimbursement Manager, Immunology Rheumatology - Washington DC Territory

Field Reimbursement Manager, Immunology Rheumatology - Washington DC Territory

Position overview: The Field Reimbursement Manager (FRM) is a field-based role focused on education, assistance, and issue resolution for patient access to Johnson & Johnson Immunology therapies. This position covers the Washington DC Territory, including DC and select Virginia locations. The FRM collaborates with healthcare providers and payers to help patients start and stay on treatment, including education on coverage, prior authorizations, claims submissions, and coding requirements.

Primary Responsibilities

• Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations for core and launch products.
• Collaborate with field support team members such as sales representatives and key account managers and serve as a reimbursement expert for the local team.
• Act with urgency to address critical access and affordability issues for patients.
• Partner with managed care colleagues to understand current policies and potential 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 assigned Immunology accounts.
• Manage territory logistics, routing, and account business planning.
• Maintain knowledge of market dynamics including coverage and coding requirements.
• Grow knowledge of hub and specialty distribution channels to support patients and practices.
• Collaborate with internal J&J departments to educate and provide insights on access and affordability solutions across multiple payer types and plans (Medicare, Medicaid, Commercial).
• Ensure compliance with ethical, legal, and training requirements.

Market Access Expertise

• Extensive knowledge of medication access channels (pharmacy and medical benefits, buy & bill, and/or assignment of benefit across multiple sites of care).
• Stay current on changes in product coverage and marketplace conditions to deliver effective materials.
• Understand and adapt to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.

Qualifications

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 in hospital and/or provider office settings.
• 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 identify solutions in a timely and efficient manner.
• Experience working with patient support HUB services.
• Valid US driver’s license and driving record in compliance with company standards.
• Ability to travel up to 50%.
• Permanent residence in the listed territory.

PREFERRED

• Immunology 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).
• Demonstrated competence with Salesforce CRM, Microsoft Word, and Excel.

Johnson & Johnson is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status or other characteristics protected by federal, state or local law.

We are committed to inclusive recruitment processes. If you require accommodation during the interview process, please contact us via the Careers page or AskGS for assistance.

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