Field Reimbursement Manager, GI – Cincinnati, OH

Johnson & Johnson Innovative MedicineDayton, OH
$102,000 - $177,100Remote

About The Position

Johnson & Johnson Innovative Medicine (JJIM) is seeking a Field Reimbursement Manager (FRM) to join the Patient Engagement and Customer Solutions (PECS) team. This field-based role will focus on supporting patients with access to J&J Immunology therapies. The PECS team is dedicated to creating personalized, seamless, and supportive experiences to help patients start and stay on treatments. The FRM will serve 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. This role requires significant on-site engagement with HCPs (up to 50% of the time) to assess education needs and facilitate collaboration. The goal is to ensure patients have the best chance at treatment success by overcoming challenges to fulfillment, on-boarding, and adherence.

Requirements

  • Bachelor’s degree (preferably in healthcare or business/public administration).
  • Minimum of 5 years of relevant professional experience.
  • Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationship.
  • 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 identifies solutions in a timely and efficient manner.
  • Superior communication skills (written and verbal) and efficient follow-through.
  • Experience in working with patient support HUB services.
  • Valid US driver’s license and a driving record in compliance with company standards.
  • Ability to consistently maintain up to 50% travel.
  • Permanent residence in the listed territory.

Nice To Haves

  • An advanced business degree (MBA), or public health (MPH)) is 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) is preferred.
  • Demonstrated competence with salesforce.com CRM use, Microsoft Word, and Excel.
  • Demonstrated commitment to learning emerging technologies, such as AI, through exploration, iteration, and apply new tools over time preferred.

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 the 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 (i.e., 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.

Benefits

  • Employees are eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).
  • This position is eligible to participate in the Company’s long-term incentive program.
  • Vacation –120 hours per calendar year
  • Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado –48 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year
  • Holiday pay, including Floating Holidays –13 days per calendar year
  • Work, Personal and Family Time - up to 40 hours per calendar year
  • Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child
  • Bereavement Leave – 240 hours for an immediate family member: 40 hours for an extended family member per calendar year
  • Caregiver Leave – 80 hours in a 52-week rolling period
  • Volunteer Leave – 32 hours per calendar year
  • Military Spouse Time-Off – 80 hours per calendar year
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