Manager, Reimbursement and Payment Policy

Johnson & Johnson Innovative Medicine•Washington, DC

1d•$102,000 - $177,100•Remote

About The Position

This role is designed for a professional with 5–10 years of professional experience in coding, coverage, and payment policy within the MedTech sector who can work independently and manage programs and vendors. The Manager will partner with cross-functional teams to deliver reliable reimbursement support, policy monitoring, and field enablement initiatives that drive market access for innovative orthopaedic technologies. This is an individual contributor role with no direct reports.

Requirements

Bachelor’s degree in Health Policy, Health Economics, Public Health, Business, or a related field.
5–10 years of relevant experience in reimbursement, health policy, market access, or healthcare consulting, preferably in the medical device or life sciences industry.
Working knowledge of U.S. reimbursement systems, including Medicare payment structures (IPPS/MS-DRG, OPPS/ASC, Physician Fee Schedule) and coding frameworks (CPT, HCPCS, ICD-10-CM/PCS).
Experience interpreting CMS regulations and translating them into business implications and written materials such as comment letters or executive briefs.
Experience managing vendors, programs, or customer support operations, including performance metrics and compliance requirements.
Strong analytical, research, project management, and problem-solving skills, with the ability to work independently and manage multiple priorities.
Excellent written and verbal communication skills, with the ability to explain complex policy to technical and non-technical audiences.
Ability to work effectively across cross-functional teams in a matrixed environment.

Nice To Haves

Advanced degree (e.g., MPH, MPP, MBA).
Experience in MedTech, orthopaedics, or surgical technologies.
Familiarity with CPT/HCPCS coding, CMS rulemaking, and payer policy development processes.
Experience with reimbursement hotlines, field reimbursement, or coding and reimbursement education.
Coding credential (e.g., CPC, CCS) or equivalent practical coding expertise.

Responsibilities

Support the Director in developing and executing payment policy strategy for the Orthopaedics portfolio across Medicare payment systems, including IPPS/MS-DRGs, OPPS/ASC, and the Physician Fee Schedule.
Conduct research and analysis to inform coding, coverage, and payment positioning for both pipeline and in-line products, including DRG, APC, and code assignment questions.
Assist in the preparation of reimbursement assessments for new product launches and lifecycle management.
Monitor and analyze CMS proposed and final rules, along with Medicaid and commercial payer policy updates, and summarize implications for internal stakeholders.
Track changes in DRG, CPT/HCPCS coding, ASC/HOPD payment systems, and emerging reimbursement trends.
Develop concise summaries, executive alerts, and briefs that translate policy updates into actionable insights.
Manage multiple projects and deadlines tied to the CMS rulemaking calendar and annual coding cycles, and communicate status and risks to leadership.
Own day-to-day management of the Orthopaedics Reimbursement Hotline (phone and email), including vendor oversight, service levels, response quality, and escalation handling.
Manage the end-to-end hotline vendor relationship, including performance review and contract and scope management.
Ensure hotline operations comply with applicable healthcare compliance, privacy, and company policies, in partnership with Legal, Compliance, and Privacy.
Analyze inquiry logs to identify trends in customer needs, coding questions, and payer issues, and report insights and recommendations to HEMA and Commercial leadership.
Promote awareness of hotline services with field teams and customers, and set metrics to measure utilization and customer satisfaction.
Lead the annual update and lifecycle management of coding and reimbursement guides, FAQs, and customer-facing resources across joint reconstruction, trauma, spine, sports medicine, and related portfolios.
Ensure all guides reflect current CPT, HCPCS, ICD-10-CM/PCS, MS-DRG, and APC information, as well as CMS payment rates and rule changes, and are accurate, compliant, and timely.
Manage the content review and approval process with Legal, Regulatory, and Compliance, and maintain version control and a publication calendar.
Design and deliver training for sales, marketing, and customer-facing teams on coding, coverage, and payment, and translate policy updates into practical field guidance.
Partner with cross-functional teams to keep reimbursement websites and resource libraries current and easy to navigate.
Assist the Director in drafting comment letters and background materials for CMS and other stakeholder engagements.
Support preparation for interactions with external stakeholders (e.g., specialty societies, trade associations, payer groups).
Conduct landscape assessments to support advocacy positions and policy strategy development.
Partner with Health Economics and Epidemiology teams to support development of evidence strategy to facilitate reimbursement and access.
Provide reimbursement inputs for Target Product Profiles (TPPs) and early-stage pipeline discussions.
Synthesize clinical, economic, and real-world evidence to inform coverage strategies.
Collaborate with Commercial, Regulatory, Legal, and Compliance to ensure reimbursement information and programs meet company and regulatory standards.

Benefits

Vacation –120 hours per calendar year
Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado –48 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year
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/foster care of a child
Bereavement Leave – 240 hours for an immediate family member: 40 hours for an extended family member per calendar year
Caregiver Leave – 80 hours in a 52-week rolling period10 days
Volunteer Leave – 32 hours per calendar year
Military Spouse Time-Off – 80 hours per calendar year
Consolidated retirement plan (pension)
Savings plan (401(k))
Long-term incentive program