Field Reimbursement Manager (Immunology Rheumatology) - Fresno, CA – Johnson & Johnson HCS, Inc.

Johnson & Johnson•Fresno, CA

7d•$100,000 - $175,000•Remote

About The Position

At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at https://www.jnj.com Johnson & Johnson Innovative Medicine’s 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 Fresno, Bakersfield, Lancaster, Palmdale, and Visalia, CA 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. An important aspect of patient’s unmet need includes helping them start and stay on their medicine for the best chance at treatment success. The Patient Engagement and Customer Solutions (PECS) organization serves patients, during their treatment journey with Janssen therapies, to help overcome challenges to fulfillment, on-boarding, and adherence. 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. 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.

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 hospital and/or provider office setting, building strong customer relationship.
Demonstrated expertise 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 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

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

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.
Extensive knowledge of medication access channels (i.e., pharmacy and medical benefits including buy & bill and/or assignment of benefit (AOB) across multiple sites of care
Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff

Benefits

This position is eligible for a company car through the Company’s FLEET program.
Subject to the terms of their respective plans, employees and/or eligible dependents are eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance.
Subject to the terms of their respective plans, employees are eligible to participate in the Company’s consolidated retirement plan (pension) and savings plan (401(k)).
Subject to the terms of their respective policies and date of hire, Employees are eligible for the following time off benefits:
Vacation –120 hours per calendar year
Sick time - 40 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
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
Subject to the terms of their respective plans, 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 period10 days
Volunteer Leave – 32 hours per calendar year
Military Spouse Time-Off – 80 hours per calendar year