Field Reimbursement Manager, Rheumatology (Atlanta, GA) Patient Engagement and Customer Solutions (PECS)

Johnson & Johnson•Atlanta, GA

16h•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 Atlanta, Georgia territory, including Atlanta West and surrounding areas such as Macon, Albany, and Valdosta. 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 and assisting healthcare providers and their office staff, and resolving issues related to patient access to J&J Immunology therapies. The role includes spending up to 50% of time onsite with healthcare providers to assess education needs and coordinate with stakeholders. The manager provides reimbursement and access expertise, helps address patient access and affordability challenges, and develops trusted relationships with assigned accounts.

Requirements

Bachelor’s degree; preferably in healthcare or business/public administration.
At least 5 years of relevant professional experience.
Account management and/or reimbursement experience in a hospital or provider-office setting, including building strong customer relationships.
Demonstrated expertise with pharmacy and medical/buy-and-bill benefits, as applicable, as well as 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 scenarios and identify solutions efficiently and promptly.
Experience working with patient support hub services.
Valid U.S. driver’s license and a driving record that complies with company standards.
Ability to maintain up to 50% travel.
Permanent residence in the listed territory.

Nice To Haves

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

Responsibilities

Educate healthcare providers on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and payer coding requirements for core and launch products.
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 urgency.
Partner with managed care colleagues to understand current policies and potential future changes.
Provide field-based reimbursement and access support, education, and problem-solving in accordance with Field Reimbursement Manager Rules of Engagement.
Build strong, trust-based relationships with customers in 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.
Develop knowledge of hub and specialty distribution channels to improve support for practices and patients.
Collaborate with internal J&J departments, including marketing, sales, medical science, SCG, IBG, HCC, and PECS.
Serve as a subject matter expert on education and insights related to access and affordability solutions across payer types and plans, including Medicare, Medicaid Managed Care, and commercial plans.
Conduct business in accordance with ethical, legal, and compliance standards, including completing required training on time.
Stay current on product coverage, access knowledge, marketplace conditions, and stakeholder practices, and deliver approved materials effectively.
Adapt to changes in the healthcare ecosystem and tailor resources and messaging to healthcare providers and their staff.