Field Reimbursement Manager, Rheumatology - Orlando, FL

Johnson & JohnsonOrlando, FL
Remote

About The Position

The Patient Engagement and Customer Solutions (PECS) team at Johnson & Johnson Innovative Medicine is seeking a Field Reimbursement Manager (FRM) to be based in Orlando, FL. This field-based role is crucial for supporting patients in their treatment journey with Janssen therapies, helping them overcome challenges related to fulfillment, onboarding, and adherence. The FRM will act as the primary field-based contact for healthcare providers (HCPs) and their office staff, providing education, assistance, and issue resolution concerning patient access to J&J Immunology therapies. A significant portion of this role (up to 50%) involves on-site engagement with HCPs to assess their educational needs and facilitate collaboration among various stakeholders. The goal is to create a personalized, helpful, and hopeful healthcare experience for patients, ensuring they can start and stay on their medication for the best possible treatment outcomes.

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.
  • Demonstrated commitment to learning emerging technologies, such as AI, through exploration, iteration, and applying new tools over time.

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

  • Inclusive work environment where each person is considered as an individual.
  • Respect for the diversity and dignity of employees and recognition of their merit.
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