At Johnson & Johnsonwe believe health is everything. Our strength in healthcare innovation empowers us to build aworld where complex diseases are prevented treated and curedwhere treatments are smarter and less invasive andsolutions are 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 more at
Job Function : Market Access
Job Sub Function : Reimbursement
Job Category : People Leader
All Job Posting Locations :
Anaheim California United States Irvine California United States of America Orange California United States Santa Ana California United States of America
Job Description :
About Inno v ati v e Medicine
Our expertise in Inno v ati v e Medicine is in f ormed and inspired by patients whose insights f uel our science-based ad v ancements. V isionaries like you work on teams that sa v e li v e s by de v e loping the medicines o f tomorrow.
Join us in de v e loping treatments f inding cures and pioneering the path f rom lab to li f e while championing patients e v e ry step o f the way.
Learn more at & Johnson Inno v ati v e Medicines Patient Engagement and Customer Solutions (PECS) team is recruiting f or a F ield Reimbursement Manager which will be a f ield-based position that will include the Santa Ana CA; Irvine CA; Anaheim CA; Orange CA; and Costa Mesa CA territories.
PECS is committed to setting the standard on Patient Experience ( Px ) building more personalized seamless and supporti v e experiences to help patients start and stay on treatments across the port f olio.
Job Description :
An important aspect o f patients unmet need includes helping them start and stay on their medicine f or the best chance at treatment success. The Patient Engagement and Customer Solutions (PECS) organization ser v e s patients during their treatment journey with Janssen therapies to help o v e rcome challenges to f ul f illment on-boarding and adherence .
The F ield Reimbursement Manager ( F R M ) is responsible f or ser v ing as the primary f ield-based lead f or education assistance and issue resolution with health car e pro v iders (HCPs) and their o f f ice sta f f with respect to patient access to J&J Immunology therapies. This role in v ol v e s in v e sting time (up to 50 %) on-site with HCP s assessing their education needs and f acilitating collaboration with v arious stakeholders.
A Day in the Li f e
E v e ry patients health car e experience is unique - shaped by personal experiences and belie f s the presence or absence o f support networks pro v ider and payer dynamics and socioeconomic f actors. F or many patients the decision to start or stop treatment is o v e rwhelming. J&J recognizes this and wants to create an experience that is personalized help f ul and hope f ul.
Primary Responsibilities :
Primary responsibilities include the f ollowing. Other duties may be assigned.
Educate HCPs on product co v e rage prior authorizations and appeals reimbursement processes claims submissions procedures and coding requirements o f payer organizations (local payers go v e rnment payers etc.) f or core and launch products.
Collaborate with f ield support team members such as sales representati v e s and key account managers and ser v e as reimbursement expert f or the local team .
Act with a sense o f urgency to address critical access and a f f ordability issues f or patients .
Partner with managed car e colleagues to understand current policies and potential f uture changes .
Conduct f ield-based reimbursement and access support education and creati v e problem-sol v ing aligned to F RM Rules o f 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 o f national regional local and account market dynamics including co v e rage and coding requirements .
Grow the knowledge o f hub and specialty distribution channels to impro v e practice and patient support needs .
Collaborate with internal J&J departments such as marketing sales medical science SCG IBG HCC and PECS . Ser v e as subject matter expert regarding education and insights on access and a f f ordability solutions across multiple payer types and plans (i.e. Medi car e Medicaid Managed Car e Commercial) .
Execute business in accordance with the highest ethical legal and compliance standards including timely and success f ul completion o f all required training .
Market Access Expertise :
Extensi v e knowledge o f medication access channels (i.e. pharmacy and medical bene f its including buy & bill and / or assignment o f bene f it (AOB) across multiple sites o f car e
Remains current on and anticipates changes in product co v e rage and access knowledge marketplace conditions and stakeholder practices to deli v e r the most e f f ecti v e deli v e ry o f appro v e d materials .
Understands and adapts to the changing health car e ecosystem to customize resourcing and messaging to HCPs and HCP sta f f
QUALI F ICATIONS :
Bachelors degree (pre f erably in health car e or business / public administration ) . An ad v anced business degree (MBA) or public health (MPH ) is pre f erred.
Minimum o f 5 years o f rele v ant pro f essional experience
Account Management and / or Reimbursement experience working in the hospital and / or pro v ider o f f ice setting building strong customer relationship .
Demonstrated expertise with both pharmacy and medical / buy & bill bene f its (as applicable) coding and billing .
Reimbursement or rele v ant managed car e experience (re v e nue cycle buy-and-bill prior authorization coding and appeals processes)
Ability to establish relationships collaborate and in f luence across a matrix organization .
Problem-sol v ing ability to na v igate challenging access scenarios and identi f ies solutions in a timely and e f f icient manner .
Experience in working with patient support HUB ser v ices .
V alid US dri v e rs license and a dri v ing record in compliance with company standards
Ability to consistently maintain up to 50% tra v e l .
Permanent residence in the listed territory
PRE F ERRED
Immunology disease state experience
Ad v anced degree and / or rele v ant certi f ications in prior authorization and / or billing and coding
Strong market access acumen as it relates to payer appro v al process es and business acumen .
Understanding o f Medi car e Medicaid and pri v ate payer initiati v e s a f f ecting reimbursement o f pharmaceutical and biotechnology products
Excellent technical knowledge and expertise in payer policy including all elements o f reimbursement (coding co v e rage and payment) is pre f erred .
Demonstrated competence with sales f CRM use Microso f t Word and Excel
# F RM2025
#LI-Remot e
Johnson & Johnson is an Equal Opportunity Employer. All quali f ied applicants will recei v e consideration f or employment without regard to race color religion sex sexual orientation gender identity age national origin disability protected v e teran status or other characteristics protected by f ederal state or local law. We acti v e ly seek quali f ied candidates who are protected v e terans and indi v iduals with disabilities as de f ined under V E V RAA and Section 503 o f the Rehabilitation Act.
Johnson & Johnson is committed to pro v iding an inter v iew process that is inclusi v e o f our applicants needs. I f you are an indi v idual with a disability and would like to request an accommodation please contact us v ia or contact AskGS to be directed to your accommodation resource.
Required Skills : Preferred Skills :
The anticipated base pay range for this position is :
$100000 - $175000
Additional Description for Pay Transparency :
Subject to the terms of their respective plans employees and / or eligible dependents are 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. Subject to the terms of their respective plans employees are eligible to participate in the Companys consolidated retirement plan (pension) and savings plan (401(k)). This position is eligible to participate in the Companys long-term incentive program. Subject to the terms of their respective policies and date of hire Employees are eligible for the following time off benefits : Vacation 120 hours per calendar year Sick time - 40 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 Condolence Leave 30 days for an immediate family member : 5 days for an extended family member Caregiver Leave 10 days Volunteer Leave 4 days Military Spouse Time-Off 80 hours Additional information can be found through the link below. Experience :
Manager
Key Skills
Business Development,Sales Experience,Microsoft Outlook,Retail Sales,Account Management,Territory Management,Analysis Skills,Outside Sales,Insurance Sales,CPT Coding,negotiation,Logistics
Employment Type : Full-Time
Experience : years
Vacancy : 1
Monthly Salary Salary : 100000 - 175000
Field Reimbursement Manager • Santa Ana, California, USA