Field Reimbursement Manager, Neuroscience – (Los Angeles, CA) – Patient Engagement & Customer Solutions (PECS)

Johnson & Johnson Innovative Medicine • Long Beach, CA

3d • $105,000 - $181,700

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is hiring a Field Reimbursement Manager for the Los Angeles territory, including Los Angeles, Pasadena, Anaheim, and Long Beach, California. PECS works to create personalized, seamless, and supportive patient experiences that help patients start and remain on treatment.

The Field Reimbursement Manager (FRM) is the primary field-based lead for educating healthcare providers (HCPs) and their office staff and resolving issues related to patient access to J&J Neuroscience therapies. The role includes spending up to 50% of time onsite with HCPs and staff to assess education needs and coordinate with stakeholders. The FRM provides reimbursement and access support, helps address fulfillment and adherence challenges, and serves as an access, fulfillment, and reimbursement resource for the local field team. The role involves travel up to 75% of the time.

The FRM builds customer relationships, manages territory logistics and account planning, monitors market and payer dynamics, and collaborates with internal J&J teams and managed care colleagues. The role requires compliance with applicable ethical, legal, and company 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 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.
• Strong written and verbal communication skills and effective follow-through.
• Experience working with patient support hub services.
• Valid U.S. driver’s license and a 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 (AOB).
• Critical-thinking skills and the ability to analyze complex quantitative and qualitative data to accelerate access.
• Intellectual curiosity and the ability to anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices.
• Ability to adapt to changes in the healthcare ecosystem and customize resources and messaging for HCPs and their staff.

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 and/or billing and coding.
• Strong market access and business acumen, particularly regarding payer approval processes.
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
• Technical expertise in payer policy and reimbursement, including coding, coverage, and payment.
• Experience using Salesforce.com CRM, Microsoft Word, and Excel.
• Commitment to learning emerging technologies such as AI through exploration, iteration, and ongoing use of new tools.

Responsibilities

• Educate HCPs on reimbursement processes, claims submissions, procedures, and payer coding requirements, including those of local and government payers.
• Collaborate with field support team members, 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.
• Respond with urgency and accountability to critical patient access and affordability issues.
• 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 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 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 regarding access and affordability solutions across payer types and plans, including Medicare, Medicaid Managed Care, and commercial plans.
• Conduct business according to ethical, legal, and compliance standards, including completing required training on time.

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 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 the birth, adoption, or foster care of a child.
• Bereavement leave: up to 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level