Jnjmedtech
Field Reimbursement Manager, Immunology Rheumatology - Long Island East, NY, Ter
Jnjmedtech, New York, New York, us, 10261
Field Reimbursement Manager, Immunology Rheumatology - Long Island East, NY, Territory
Field-based role with Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team. This position will cover Bay Shore, Huntington Station, Brentwood, Patchogue and Huntington (NY) territories and involve education, assistance, and issue resolution with healthcare providers (HCPs) to support patient access to J&J Immunology therapies. Up to 50% on-site work with HCPs to assess education needs and facilitate collaboration with stakeholders.
Job Description An important aspect of patient unmet needs includes helping them start and stay on their medicine for the best chance at treatment success. The Field Reimbursement Manager (FRM) serves as the primary field-based lead for education, assistance, and issue resolution with HCPs and their office staff regarding patient access to J&J Immunology therapies.
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 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 and 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 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 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 hospital and/or provider office settings, building strong customer relationships.
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 in 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 of payer policy, including coverage, coding, and payment.
Experience with Salesforce.com CRM, Microsoft Word, and Excel.
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. Reasonable accommodations are available on request during the recruitment process.
Base pay range: $100,000 - $175,000. This position may be eligible for company-sponsored benefits and time-off programs as described in company policy.
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Job Description An important aspect of patient unmet needs includes helping them start and stay on their medicine for the best chance at treatment success. The Field Reimbursement Manager (FRM) serves as the primary field-based lead for education, assistance, and issue resolution with HCPs and their office staff regarding patient access to J&J Immunology therapies.
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 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 and 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 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 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 hospital and/or provider office settings, building strong customer relationships.
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 in 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 of payer policy, including coverage, coding, and payment.
Experience with Salesforce.com CRM, Microsoft Word, and Excel.
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. Reasonable accommodations are available on request during the recruitment process.
Base pay range: $100,000 - $175,000. This position may be eligible for company-sponsored benefits and time-off programs as described in company policy.
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