Field Reimbursement Manager, Gastroenterology (Austin/San Antonio, Texas) Patient Engagement and Customer Solutions (PECS)

Johnson & Johnson•San Antonio, TX

3d•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 San Antonio/Austin, Texas territory. 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 resource for educating healthcare providers and their office staff, assisting with access issues, and resolving challenges to patient access to J&J Immunology therapies. The role includes spending up to 50% of time on-site with healthcare providers to assess education needs and coordinate with relevant stakeholders. The manager provides reimbursement and access education, problem-solving, and insights across payer types and plans, while working in accordance with applicable ethical, legal, and compliance standards.

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 provider-office setting, including building strong customer relationships.
Demonstrated expertise with pharmacy and medical/buy-and-bill benefits, 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 in a timely and efficient manner.
Strong written and verbal communication skills and efficient follow-through.
Experience working with patient support hub services.
Valid U.S. driver’s license and a driving record that complies with company standards.
Ability to consistently 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 acumen relating 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.
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 act as the local team’s reimbursement expert.
Address critical patient access and affordability issues with a sense of 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 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, including Medicare, Medicaid Managed Care, and commercial plans.
Conduct business in accordance with ethical, legal, and compliance standards, including timely completion of required training.
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 to tailor resources and messaging for healthcare providers and their staff.

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 specified for employees residing 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.