Field Reimbursement Manager, Neuroscience – (San Diego, CA) – Patient Engagement & Customer Solutions (PECS)
About The Position
Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is hiring a Field Reimbursement Manager (FRM) for the San Diego territory, including San Diego, Las Vegas, San Bernardino, and Riverside. PECS works to create personalized, seamless, and supportive patient experiences that help patients start and remain on treatment. The FRM serves as the primary field-based lead for educating healthcare providers (HCPs) and office staff, providing assistance, and resolving issues related to patient access to J&J Neuroscience therapies. The role includes spending up to 50% of time on-site with HCPs and their staff to assess education needs and facilitate collaboration with stakeholders. The position also involves travel up to 75% of the time. The manager provides expertise on reimbursement, access, and affordability across payer types and plans, including Medicare, Medicaid Managed Care, and commercial plans. The role works with field support teams and internal J&J departments, maintains account and territory plans, and ensures business is conducted according to 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 customer relationships.
- Expertise in pharmacy and medical/buy-and-bill benefit design, coding, billing, prior authorizations, office operations, and appeals.
- 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.
- 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 compliant with company standards.
- Permanent residence in the listed territory.
- Ability to travel 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 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 applying new tools over time.
- Critical thinking and ability to analyze complex quantitative and qualitative data to accelerate access.
- Intellectual curiosity and ability to anticipate changes in product coverage, marketplace conditions, and stakeholder practices.
Responsibilities
- Educate HCPs on payer reimbursement processes, claims submissions, procedures, and coding requirements.
- 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.
- Address critical patient access and affordability issues with urgency and accountability.
- Partner with managed care colleagues to understand current policies and potential future changes.
- Provide field-based reimbursement and access support, education, and creative problem-solving consistent 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 grow knowledge of national, regional, local, and account market dynamics, including coverage and coding requirements.
- Expand 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.
- Serve as a subject matter expert on education and insights regarding access and affordability solutions across payer types and plans.
- Conduct business in accordance with ethical, legal, and compliance standards and complete required training on time.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
