Field Reimbursement Manager - (Albany, NY) Rheumatology

Johnson & Johnson•Albany, NY

5d•Onsite

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is seeking a field-based Field Reimbursement Manager based in Albany, New York. The role serves as the primary field-based lead for education, assistance, and issue resolution for healthcare providers and their office staff regarding patient access to J&J Immunology therapies. It includes spending up to 50% of working time on-site with healthcare providers to assess educational needs and facilitate collaboration among stakeholders. The FRM helps provider offices address patient access and affordability challenges, supporting patients as they start and remain on treatment. The position works with local field teams and internal departments, builds trusted relationships across assigned Immunology accounts, and provides expertise on coverage, reimbursement, and access across payer types and care settings. The role requires managing territory logistics and business planning, staying current on market and policy changes, and operating in accordance with legal, ethical, and compliance requirements.

Requirements

Bachelor’s degree; healthcare or business/public administration is preferred.
At least 5 years of relevant professional experience.
Account management and/or reimbursement experience in a hospital or provider-office setting, including building customer relationships.
Expertise with pharmacy and medical/buy-and-bill benefits, as applicable, 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 in a timely manner.
Experience working with patient support hub services.
Valid U.S. driver’s license and driving record that complies with company standards.
Ability to maintain up to 50% travel.
Permanent residence in 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 and/or billing and coding.
Strong market access and business acumen, including knowledge of 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 elements, including coding, coverage, and payment.
Demonstrated competence with 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 and office staff 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 team members, serving as the reimbursement expert for the local team.
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 FRM 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 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 in compliance with ethical, legal, and company standards, including completing required training on time.
Maintain expertise in medication access channels, including pharmacy and medical benefits, buy-and-bill, and assignment of benefit across multiple sites of care.
Monitor and anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices, and deliver approved materials effectively.
Adapt to changes in the healthcare ecosystem to tailor resources and messaging for healthcare providers and their staff.

Benefits

Company consolidated retirement plan (pension) and savings plan (401(k)), subject to plan terms.
Vacation: 120 hours per calendar year, subject to policy and hire date.
Sick time: 40 hours per calendar year, with different amounts specified for Colorado and Washington residents.
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.