Field Reimbursement Manager, Immunology Rheumatology - Lower Manhattan, NY, Terr

Overview

Field Reimbursement Manager, Immunology Rheumatology - Lower Manhattan, NY, Territory at Johnson & Johnson MedTech is a field-based role supporting patient access to J&J Immunology therapies. This position will involve working with healthcare providers (HCPs) and office staff to educate on education, access, and reimbursement processes, with significant on-site time distributed across the territory.

Job Details

Location: New York, New York, United States
Territory: Brooklyn, NY; Manhattan, NY; Queens, NY; Staten Island, NY; and surrounding areas

Job Description

Johnson & Johnson Innovative Medicines Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager (FRM). The FRM serves as the primary field-based lead for education, assistance, and issue resolution with HCPs and staff to facilitate patient access to J&J Immunology therapies. The role may involve up to 50% time on-site with HCPs to assess education needs and coordinate with internal stakeholders.

Primary 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 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 (marketing, sales, medical science, SCG, IBG, HCC, and PECS). Serve as subject matter expert on education and insights on access and affordability solutions across multiple payer types and plans (e.g., Medicare, Medicaid, Commercial).
• Execute business with high ethical, legal, and compliance standards and complete required training.

Market Access Expertise

• Extensive knowledge of medication access channels (pharmacy and medical benefits) including buy & bill and/or assignment of benefit (AOB) across multiple sites of care.
• Stay current on product coverage, 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 staff.

Qualifications

Required

• Bachelors degree (preferably in healthcare or business/public administration). An MBA or MPH is a plus.
• Minimum of 5 years of relevant professional experience.
• Account management and/or reimbursement experience in hospital or provider settings; strong customer relationships.
• Experience 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).
• Ability to collaborate across a matrix organization and influence others.
• Problem-solving ability to navigate complex access scenarios and provide timely solutions.
• Experience with patient support HUB services.
• Valid US drivers license with acceptable driving record
• Ability to travel up to 50%
• Permanent residence in the listed territory

Preferred

• Immunology disease state experience
• Advanced degree or certifications in prior authorization and/or billing and coding
• Strong market access acumen related to payer approval processes and business sense
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement
• Excellent knowledge of payer policy, including coding, coverage, and payment
• Experience with Salesforce CRM and MS Office (Word, Excel)

Pay and Benefits
Estimated base pay range: $100,000 - $175,000. Eligible to participate in company-wide benefits and plans. See company benefits page for details.

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 provide accommodations in the interview process upon request.