Field Reimbursement Manager, Neuroscience – (Seattle, WA) – Patient Engagement & Customer Solutions (PECS)
About The Position
Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is seeking a Field Reimbursement Manager to support access to J&J Neuroscience therapies across a territory that includes Seattle and Tacoma, Washington; Coeur d’Alene, Idaho; and Anchorage, Alaska. PECS works to create personalized, seamless, and supportive patient experiences that help patients start and stay on treatment. The Field Reimbursement Manager is the primary field-based lead for educating healthcare providers and their office staff, assisting with reimbursement, and resolving issues related to patient access. The role includes spending up to 50% of time on-site with HCPs and staff, assessing their education needs, and facilitating collaboration with relevant stakeholders. The position also involves travel up to 75% of the time. The manager provides reimbursement and access education, supports compliant access and fulfillment discussions, and helps practices address barriers to treatment. The role requires strong knowledge of pharmacy and medical benefit pathways, payer requirements, coding, billing, prior authorizations, and appeals. The manager works with internal and external partners to deliver patient access and affordability support while following applicable ethical, legal, and compliance standards.
Requirements
- Bachelor’s degree; a degree in healthcare or business/public administration is preferred.
- At least 5 years of relevant professional experience.
- Account management and/or reimbursement experience in a provider-office setting, including building strong customer relationships.
- Expertise in pharmacy and medical/buy-and-bill benefit design, coding, billing, prior authorizations, office operations, and appeals processes.
- Reimbursement or relevant managed care experience, such as revenue cycle, buy-and-bill, prior authorization, coding, and appeals.
- Ability to establish relationships, collaborate, and influence across a matrix organization.
- Problem-solving ability to navigate challenging access scenarios and identify solutions efficiently.
- Strong written and verbal communication skills and efficient follow-through.
- Experience working with patient support hub services.
- Valid U.S. driver’s license and driving record that complies with company standards.
- Permanent residence in the listed territory.
- Extensive knowledge of medication access channels, including pharmacy and medical benefits, buy-and-bill, and/or assignment of benefit.
- Critical-thinking ability and ability to analyze complex quantitative and qualitative data to accelerate access.
- Ability to stay current on product coverage, access knowledge, marketplace conditions, and stakeholder practices, and to adapt support and messaging to HCPs and staff.
- Ability to perform the role’s travel requirements, which may be up to 75% of the time.
Nice To Haves
- Advanced business degree (MBA) or public health degree (MPH).
- Neuroscience disease-state experience.
- Advanced degree and/or relevant certifications in prior authorization, billing, or coding.
- Strong market access acumen related to payer approval processes and business acumen.
- Understanding of Medicare, Medicaid, and private-payer initiatives affecting pharmaceutical and biotechnology reimbursement.
- Technical expertise in payer policy and reimbursement, including coding, coverage, and payment.
- Experience with Salesforce.com CRM, Microsoft Word, and Excel.
- Commitment to learning emerging technologies, such as AI, through exploration and iteration.
Responsibilities
- Educate healthcare providers on payer reimbursement processes, claims submissions, procedures, and coding requirements.
- Collaborate with field support colleagues, including sales representatives and key account managers, and serve as the local team’s access, fulfillment, and reimbursement expert.
- Lead compliant access and fulfillment discussions with field support team members.
- Use data and account management skills to proactively address access barriers.
- Address critical patient access and affordability issues with urgency and accountability.
- Partner with managed care colleagues to understand current policies and potential policy changes.
- Provide field-based reimbursement and access support, education, and problem-solving in accordance with FRM Rules of Engagement.
- Build strong, trust-based relationships with customers in assigned accounts.
- Manage territory logistics, routing, and account business planning.
- Maintain and expand knowledge of national, regional, local, and account market dynamics, including coverage and coding requirements.
- Develop knowledge of hub and specialty distribution channels to improve practice and patient support.
- Collaborate with internal departments, including marketing, sales, medical science, SCG, IBG, HCC, and PECS.
- Serve as a subject matter expert on education and insights about access and affordability solutions across payer types and plans.
- Conduct business according to ethical, legal, and compliance standards, including completing required training on time.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
