Field Reimbursement Manager - GI - Orange County, CA

Johnson & Johnson Innovative Medicine•Long Beach, CA

5d•$105,000 - $181,700•Onsite

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is recruiting a field-based Field Reimbursement Manager for the Orange County, California territory. PECS works to create personalized, seamless, and supportive patient experiences that help patients start and stay on treatment. The Field Reimbursement Manager serves as the primary field-based lead for education, assistance, and issue resolution for healthcare providers and their office staff concerning patient access to J&J Immunology therapies. The role includes spending up to 50% of working time on-site with healthcare providers, assessing their education needs, and facilitating collaboration with stakeholders. The manager provides reimbursement and access expertise, helps address patient access and affordability challenges, and supports practices in navigating payer requirements and reimbursement processes. The role requires territory management, collaboration across internal and field teams, and ongoing knowledge of payer policies, market dynamics, coverage, coding, and specialty distribution channels. The successful candidate conducts business according to applicable ethical, legal, and compliance standards.

Requirements

Bachelor’s degree; a degree in healthcare, business, or 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.
Demonstrated expertise with pharmacy and medical/buy-and-bill benefits, coding, and billing.
Reimbursement or relevant managed care experience, such as revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes.
Ability to build 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.
Ability to maintain up to 50% travel.
Permanent residence in the listed territory.

Nice To Haves

Advanced business degree (MBA), public health degree (MPH), or another advanced degree.
Immunology disease-state experience.
Relevant certifications in prior authorization and/or billing and coding.
Strong market access expertise 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 and 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 Field Reimbursement Manager Rules of Engagement.
Build strong, trust-based relationships with customers in assigned Immunology 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 practice and patient support.
Collaborate with internal J&J departments, including marketing, sales, medical science, SCG, IBG, HCC, and PECS; provide expertise and insights on 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.
Stay current on product coverage, access knowledge, marketplace conditions, and stakeholder practices to deliver approved materials effectively.
Adapt to changes in the healthcare ecosystem to tailor resourcing and messaging for healthcare providers and their staff.

Benefits

Company consolidated retirement plan (pension) and 401(k) savings plan, subject to plan terms.
Eligibility to participate in the 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 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 a child’s birth, adoption, or foster care placement.
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.
Military spouse time off: 80 hours per calendar year.