Field Reimbursement Manager (Immunology Dermatology)- Mobile, AL - Johnson & Johnson HCS, Inc.

Johnson & Johnson-posted 3 months ago
$100,000 - $175,000/Yr
Full-time • Mid Level
Dothan, AL
5,001-10,000 employees
Chemical Manufacturing
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The Field Reimbursement Manager (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, with respect to patient access to J&J Immunology therapies. This role involves investing time (up to 50%) on-site with HCPs, assessing their education needs and facilitating collaboration with various stakeholders. The Patient Engagement and Customer Solutions (PECS) organization serves patients during their treatment journey with Janssen therapies, to help overcome challenges to fulfillment, onboarding, and adherence. Every patient's healthcare experience is unique - shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start or stop treatment is overwhelming. J&J recognizes this, and wants to create an experience that is personalized, helpful, and hopeful.

  • Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations.
  • 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.
  • 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 the hospital and/or 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.
  • 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.
  • 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).
  • Demonstrated competence with salesforce.com CRM use, Microsoft Word, and Excel.
  • Medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance.
  • 401(k) retirement plan.
  • Vacation - 120 hours per calendar year.
  • Sick time - 40 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.
  • Condolence Leave - 30 days for an immediate family member; 5 days for an extended family member.
  • Caregiver Leave - 10 days.
  • Volunteer Leave - 4 days.
  • Military Spouse Time-Off - 80 hours.
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