Field Reimbursement Manager - (Albany, NY) Rheumatology

Johnson & Johnson Innovative Medicine•Hopewell Township, NJ

7d•$102,000 - $177,100•Onsite

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is hiring a field-based Field Reimbursement Manager based in Albany, New York. The role serves as 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 manager may spend up to 50% of their time on-site with healthcare providers, assessing education needs and facilitating collaboration with relevant stakeholders. PECS works to create personalized, seamless, and supportive patient experiences that help patients start and remain on treatment. The Field Reimbursement Manager provides reimbursement and access support to healthcare practices, including guidance on payer coverage, authorization, appeals, claims, procedures, and coding. The role also develops customer relationships, collaborates with internal and external partners, manages territory activities, and maintains knowledge of market, payer, and distribution dynamics. Work must comply with applicable ethical, legal, and company standards.

Requirements

Bachelor’s degree; a healthcare or business/public administration focus 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 strong customer relationships.
Demonstrated 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 promptly and efficiently.
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.
Extensive knowledge of medication access channels, including pharmacy and medical benefits, buy-and-bill and/or assignment of benefit (AOB), across multiple sites of care.

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 acumen related to payer approval processes and business acumen.
Understanding of Medicare, Medicaid, and private payer initiatives affecting pharmaceutical and biotechnology product reimbursement.
Excellent technical knowledge of payer policy, 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.

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 field support team members, including sales representatives and key account managers, and serve 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 FRM Rules of Engagement.
Build strong, trust-based relationships with customers across 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; provide subject-matter expertise on access and affordability solutions across payer types and plans.
Conduct business according to ethical, legal, and compliance standards, including completing required training on time.
Stay current on and anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices to deliver approved materials effectively.
Adapt to changes in the healthcare ecosystem and tailor resources and messaging for healthcare providers and their staff.

Benefits

Company consolidated retirement plan (pension) and 401(k) savings plan, subject to plan terms.
Vacation: 120 hours per calendar year.
Sick time: 40 hours per calendar year, with stated higher allocations for eligible employees in Colorado and 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: 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.