Field Reimbursement Manager (Immunology Rheumatology) (Springfield, IL) Johnson

Overview

Field Reimbursement Manager (Immunology Rheumatology) (Springfield, IL) Johnson & Johnson HCS, Inc. The Field Reimbursement Manager will be a field-based position serving Saint Louis, MO; Springfield, IL; Peoria, IL; Terre Haute, IN; and Florissant, MO territories. PECS is committed to setting the standard on Patient Experience (Px), building more personalized, seamless, and supportive experiences to help patients start and stay on treatments across the portfolio.

Johnson & Johnson Innovative Medicines Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Saint Louis, MO; Springfield, IL; Peoria, IL; Terre Haute, IN; and Florissant, MO territories.

The FRM is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff regarding patient access to J&J Immunology therapies, including up to 50% on-site time with HCPs.

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 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 (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).
• Remain current on and anticipate changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver effective materials.
• Understand and adapt to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.

Qualifications

• Bachelors degree (preferably in healthcare or business/public administration). An MBA or MPH is preferred.
• Minimum of 5 years of relevant professional experience.
• Account Management and/or Reimbursement experience in hospital and/or provider office settings, with strong customer relationship skills.
• 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).
• Ability to establish relationships, collaborate, and influence across a matrix organization.
• Problem-solving ability to navigate challenging access scenarios and identify solutions promptly.
• Experience in working with patient support HUB services.
• Valid US drivers license and driving record in compliance with company standards.
• Ability to travel up to 50% and maintain permanent residence in the listed territory.

Preferred

• Immunology disease state experience.
• Advanced degree and/or certifications in prior authorization and/or billing and coding.
• Strong market access acumen related to payer approval processes.
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
• Technical knowledge in payer policy (coding, coverage, and payment).
• Experience with Salesforce CRM and Microsoft Word/Excel.

Seniority level: Not Applicable

Employment type: Full-time

Job function: Finance and Sales

Industries: Hospitals and Health Care

Equity and Benefits

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. The anticipated base pay range is $100,000 - $175,000. See care benefits information at the provided links in the original posting for details on employee benefits and time off.

Additional description for pay transparency and benefits information provided in the original posting.

If you would like to request an accommodation during the interview process, please contact Johnson & Johnson careers or AskGS.