Field Reimbursement Manager, Rheumatology - Cincinnati, OH

Johnson & Johnson Innovative Medicine•Dayton, OH

2d•$102,000 - $177,100•Remote

About The Position

The Patient Engagement and Customer Solutions (PECS) team at Johnson & Johnson Innovative Medicine is seeking a Field Reimbursement Manager (FRM). This field-based role will cover Dayton and Cincinnati, Ohio. The PECS organization is dedicated to enhancing the patient experience by providing personalized, seamless, and supportive experiences to help patients begin and continue their treatment journeys with Janssen therapies. The FRM will act as the primary field-based contact for healthcare providers (HCPs) and their office staff, offering education, assistance, and issue resolution 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 educational needs and facilitate collaboration among stakeholders. The goal is to ensure patients can start and stay on their medication for optimal 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 relationships.
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 identify 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.
Rheumatology 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.
Address critical access and affordability issues for patients with a sense of urgency.
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

Consolidated retirement plan (pension)
Savings plan (401(k))
Long-term incentive program
Vacation – 120 hours per calendar year
Sick time - 40 hours per calendar year (varies by state)
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