Johnson & Johnson MedTech
Field Reimbursement Manager (Immunology Rheumatology) - San Francisco South, CA
Johnson & Johnson MedTech, San Francisco, California, United States, 94199
Overview Field Reimbursement Manager (Immunology Rheumatology) - San Francisco South, CA – Johnson & Johnson HCS, Inc. The Field Reimbursement Manager (FRM) is a field-based role serving as the primary education, assistance, and issue-resolution lead with healthcare providers and their staff for patient access to J&J Immunology therapies. This position involves on-site work with HCPs up to 50% of the time and collaboration with multiple stakeholders to address education, access, and affordability needs.
Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. 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 knowledge of hub and specialty distribution channels to support practice and patient 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 (e.g., 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. Market Access Expertise
Extensive knowledge of medication access channels (pharmacy and medical benefits, including buy & bill and/or assignment of benefit across multiple sites of care). Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver effective materials. Understands and adapts 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, 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 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 related 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). Experience with Salesforce.com CRM, Microsoft Word, and Excel. Compensation and Benefits The expected base pay range for this position is $100,000 to $175,000. This position is eligible for a company car through the Company’s Fleet program. Eligible employees may participate in medical, dental, vision, life insurance, short- and long-term disability, and other benefits. Eligible employees may participate in the consolidated retirement plan (pension) and 401(k). Time-off benefits include Vacation, Sick time, Holidays, Personal and Family Time, Parental Leave, Condolence Leave, Caregiver Leave, Volunteer Leave, and Military Spouse Time-Off. For more information, see the company benefits page. 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 law. We accommodate applicants with disabilities upon request. If you need an accommodation, contact our careers team. Job Details
Seniority level: Not Applicable Employment type: Full-time Job function: Finance and Sales Industries: Hospitals and Health Care
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Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. 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 knowledge of hub and specialty distribution channels to support practice and patient 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 (e.g., 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. Market Access Expertise
Extensive knowledge of medication access channels (pharmacy and medical benefits, including buy & bill and/or assignment of benefit across multiple sites of care). Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver effective materials. Understands and adapts 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, 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 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 related 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). Experience with Salesforce.com CRM, Microsoft Word, and Excel. Compensation and Benefits The expected base pay range for this position is $100,000 to $175,000. This position is eligible for a company car through the Company’s Fleet program. Eligible employees may participate in medical, dental, vision, life insurance, short- and long-term disability, and other benefits. Eligible employees may participate in the consolidated retirement plan (pension) and 401(k). Time-off benefits include Vacation, Sick time, Holidays, Personal and Family Time, Parental Leave, Condolence Leave, Caregiver Leave, Volunteer Leave, and Military Spouse Time-Off. For more information, see the company benefits page. 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 law. We accommodate applicants with disabilities upon request. If you need an accommodation, contact our careers team. Job Details
Seniority level: Not Applicable Employment type: Full-time Job function: Finance and Sales Industries: Hospitals and Health Care
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