Field Reimbursement Manager Jobs

About The Position

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.
• Expertise with pharmacy and medical/buy-and-bill benefit design, coding, billing, prior authorizations, office operations, and appeals processes.
• 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 timely, efficient solutions.
• 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.
• Permanent residence in the listed territory.
• Extensive knowledge of medication access channels, including pharmacy and medical benefits, buy-and-bill, and/or assignment of benefit.
• Critical-thinking skills and ability to analyze complex quantitative and qualitative data to accelerate access.
• Intellectual curiosity and ability to anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices.
• Ability to adapt to the changing healthcare ecosystem and customize resources and messaging for healthcare providers and their staff.

Nice To Haves

• Advanced business degree (MBA) or public health degree (MPH).
• Neuroscience disease-state experience.
• Advanced degree and/or relevant certifications in prior authorization and/or billing and coding.
• Strong market access acumen concerning 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, including reimbursement 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 reimbursement processes, claims submissions, procedures, and payer coding requirements.
• Collaborate with field support team members, including sales representatives and key account managers, and serve as the local team’s access, fulfillment, and reimbursement expert.
• Lead compliant access and fulfillment discussions with field support team members.
• Use data and account management skills to proactively address access barriers.
• Address critical patient access and affordability issues with urgency and accountability.
• Partner with managed care colleagues to understand current policies and potential future changes.
• Provide field-based reimbursement and access support, education, and problem-solving aligned with FRM Rules of Engagement.
• Build trust-based relationships with customers in assigned 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.
• Expand 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 subject matter expertise and insights on access and affordability solutions across payer types and plans, including Medicare, Medicaid Managed Care, and commercial plans.
• Conduct business according to ethical, legal, and compliance standards, including completing required training on time.