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Field Reimbursement Manager Immunology-Dermatology-Denver/Colorado Springs, CO
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Johnson & Johnson Innovative Medicine's Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position. PECS is committed to setting the standard on Patient Experience (Px), building more personalized, seamless, and supportive experiences to help patients start and stay on treatments across the portfolio.
At Johnson & Johnson,we believe health is everything. Our strength in healthcare innovation empowers us to build aworld where complex diseases are prevented, treated, and cured,where treatments are smarter and less invasive, andsolutions are personal.Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity.Learn more at
For more than 130 years, diversity, equity & inclusion (DEI) has been a part of our cultural fabric at Johnson & Johnson and woven into how we do business every day. Rooted in Our Credo, the values of DEI fuel our pursuit to create a healthier, more equitable world. Our diverse workforce and culture of belonging accelerate innovation to solve the world's most pressing healthcare challenges. We know that the success of our business - and our ability to deliver meaningful solutions - depends on how well we understand and meet the diverse needs of the communities we serve. Which is why we foster a culture of inclusion and belonging where all perspectives, abilities and experiences are valued and our people can reach their potential.
At Johnson & Johnson, we all belong.
Job Description:
An important aspect of patient unmet need includes helping them start and stay on their medicine for the best chance at treatment success. The Patient Engagement and Customer Solutions (PECS) organization serves patients, during their treatment journey with Janssen therapies, to help overcome challenges to fulfillment, on-boarding, and adherence.
The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies. This role involves investing time (up to 50%) on-site with HCPs, assessing their education needs and facilitating collaboration with various stakeholders.
A Day in the Life
Every patient's healthcare experience is unique - shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start or stop a treatment is overwhelming. J&J recognizes this, and wants to create an experience that is personalized, helpful, and hopeful.
Primary Responsibilities:
- Primary responsibilities include the following. Other duties may be assigned.
- 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.
- Extensive knowledge of medication access channels (i.e., pharmacy and medical benefit including buy & bill and/or assignment of benefit (AOB) across multiple sites of care.
- Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
- Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.
Required Qualifications:
- Bachelor's degree (preferably in healthcare or business/public administration). An advanced business degree (MBA), or public health (MPH)) is preferred.
- 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.
- 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) is preferred.
- Demonstrated competence with CRM use, Microsoft Word, and Excel
Employees and/or eligible dependents may be eligible to participate in the following Company sponsored employee benefit programs: medical, dental, vision, life insurance, short- and long-term disability, business accident insurance, and group legal insurance.
Employees may be eligible to participate in the Company's consolidated retirement plan (pension) and savings plan (401(k)).
This position is eligible to participate in the Company's long-term incentive program.
Employees are eligible for the following time off benefits:
• Vacation - up to 120 hours per calendar year.
• Sick time - up to 40 hours per calendar year; for employees who reside in the State of Washington - up to 56 hours per calendar year.
• Holiday pay, including Floating Holidays - up to 13 days per calendar year.
• Work, Personal and Family Time - up to 40 hours per calendar year.
Additional information can be found through the link below.
For additional general information on Company benefits, please go to:
Johnson & Johnson is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
For more information on how we support the whole health of our employees throughout their wellness, career and life journey, please visit .]
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