Field Reimbursement Manager, Gastroenterology (Austin/San Antonio, Texas) Patient Engagement and Customer Solutions (PECS)

Johnson & Johnson Innovative Medicine•Hopewell Township, NJ

5d•$105,000 - $181,700•Onsite

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is hiring a field-based Field Reimbursement Manager for the Austin/San Antonio, Texas territory. PECS works to create personalized, supportive patient experiences and help patients overcome challenges to treatment fulfillment, onboarding, and adherence. The Field Reimbursement Manager serves as the primary field-based lead for educating healthcare providers and office staff, assisting with access issues, and resolving problems related to patient access to J&J Immunology therapies. The role involves spending up to 50% of the time on-site with healthcare providers, assessing their education needs, and collaborating with stakeholders. The manager educates provider offices about product coverage, prior authorizations, appeals, reimbursement processes, claims submissions, procedures, and payer coding requirements. The role also provides field-based access support and problem-solving, builds customer relationships, manages territory logistics and account planning, monitors market and payer changes, and collaborates with internal teams and managed care colleagues. The position requires maintaining current expertise in pharmacy and medical benefit access channels, including buy-and-bill and assignment of benefit across sites of care, and conducting business in accordance with legal, ethical, and compliance standards.

Requirements

Bachelor’s degree; a degree in healthcare, business, or 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 customer relationships.
Demonstrated expertise with pharmacy and medical/buy-and-bill benefits, coding, and billing.
Reimbursement or relevant managed care experience, including 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 situations and identify solutions efficiently and promptly.
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.
Ability to consistently travel up to 50%.
Permanent residence within the listed territory.

Nice To Haves

Advanced business degree (MBA) or public health degree (MPH).
Immunology disease-state experience.
Advanced degree and/or relevant certifications in prior authorization, billing, and coding.
Strong market access acumen related to payer approval processes and business acumen.
Understanding of Medicare, Medicaid, and private payer initiatives that affect reimbursement of pharmaceutical and biotechnology products.
Technical knowledge and expertise in payer policy and reimbursement elements, including coding, coverage, and payment.
Competence using Salesforce.com CRM, Microsoft Word, and Excel.
Commitment to learning emerging technologies, such as AI, through exploration and iteration and applying new tools over time.

Responsibilities

Educate healthcare providers and office staff about product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and payer coding requirements.
Collaborate with sales representatives, key account managers, and other field support colleagues, serving as the local team’s reimbursement expert.
Address critical patient access and affordability issues with a sense of urgency.
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 across assigned Immunology accounts.
Manage territory logistics, routing, and account business planning.
Maintain 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 J&J departments, including marketing, sales, medical science, SCG, IBG, HCC, and PECS.
Provide subject matter expertise and insights on access and affordability solutions across payer types and plans, including Medicare, Medicaid Managed Care, and commercial plans.
Conduct business according to applicable ethical, legal, and compliance standards and complete required training on time.
Keep current with and anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices.
Adapt to changes in the healthcare ecosystem to customize resources and messaging for healthcare providers and their staff.

Benefits

Eligible to participate in the Company’s long-term incentive program.
Vacation: 120 hours per calendar year.
Sick time: 40 hours per calendar year, with different annual amounts for employees residing in Colorado or Washington.
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 a child’s birth, adoption, or foster care placement.
Bereavement leave: 240 hours for an immediate family member and 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.