Field Reimbursement Manager - GI - Orange County, CA

Johnson & Johnson Innovative Medicine•Long Beach, CA

3d•$102,000 - $177,100•Onsite

About The Position

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions team is hiring a field-based Field Reimbursement Manager for the Orange County, California territory. The role supports patients’ ability to start and remain on J&J Immunology therapies by helping healthcare providers and office staff address access, reimbursement, and affordability challenges. The manager serves as the primary field-based lead for education, assistance, and issue resolution, spending up to 50% of their time on-site with healthcare providers to assess education needs and coordinate with stakeholders. The position requires extensive knowledge of medication access channels, including pharmacy and medical benefits, buy-and-bill, and assignment of benefit across multiple sites of care. The manager keeps current on coverage, coding, marketplace conditions, and stakeholder practices, and adapts support and approved messaging to the changing healthcare environment. The role collaborates across field teams and internal departments and operates in accordance with applicable ethical, legal, and compliance standards.

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 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 efficiently and promptly.
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 meets 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 expertise regarding payer approval processes and business acumen.
Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
Excellent technical knowledge of payer policy and reimbursement elements, including coding, coverage, and payment.
Competence using Salesforce.com CRM, Microsoft Word, and Excel.
Commitment to learning emerging technologies, such as AI, through exploration, iteration, and application of 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 sales representatives, key account managers, and other field support team members, serving 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 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 support for practices and patients.
Collaborate with internal J&J departments, including marketing, sales, medical science, SCG, IBG, HCC, and PECS, and provide expertise on access and affordability solutions across payer types and plans.
Execute business in accordance with ethical, legal, and compliance standards, including completing required training on time.
Keep current on and anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices.
Adapt to changes in the healthcare ecosystem to tailor resourcing and messaging to healthcare providers and their staff.

Benefits

Eligibility to participate in the company’s consolidated retirement plan (pension) and 401(k) savings plan, subject to plan terms.
Eligibility 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 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: 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.