Field Reimbursement Manager Jobs

About The Position

Requirements

• Bachelor’s degree (preferably in healthcare or business/public administration).
• Minimum of 5 years of relevant professional experience.
• Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationship.
• Demonstrated expertise with both pharmacy and medical/buy & bill benefits, coding, and billing.
• Reimbursement or relevant managed care experience (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 identifies solutions in a timely and efficient manner.
• Superior communication skills (written and verbal) and efficient follow-through.
• Experience in working with patient support HUB services.
• Valid US driver’s license and a driving record in compliance with company standards.
• Ability to consistently maintain up to 50% travel.
• Permanent residence in the listed territory.

Nice To Haves

• Immunology disease state experience.
• Advanced degree and/or relevant certifications in prior authorization and/or billing and coding.
• Strong market access acumen as it relates to payer approval processes and business acumen.
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products.
• Excellent technical knowledge and expertise in payer policy, including all elements of reimbursement (coding, coverage, and payment).
• Demonstrated competence with salesforce.com CRM use, Microsoft Word, and Excel.

Responsibilities

• Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and launch products.
• Collaborate with field support team members such as sales representatives and key account managers and serve as reimbursement expert for the local team.
• Act with a sense of urgency to address critical access and affordability issues for patients.
• Partner with managed care colleagues to understand current policies and potential future changes.
• Conduct field-based reimbursement and access support, education and creative problem-solving aligned to FRM Rules of Engagement.
• Build strong, trust-based relationships with customers in all 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.
• Grow the knowledge of hub and specialty distribution channels to improve practice and patient support needs.
• Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS.
• Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
• Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training.