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Field Reimbursement Manager (Rheumatology) - San Francisco, CA North

Field Reimbursement Manager (Rheumatology) - San Francisco, CA North

J&J Family of CompaniesSan Francisco, CA, US
1 day ago
Job type
  • Permanent
Job description

Field Reimbursement Manager

Our expertise in Innovative Medicine is informed and inspired by patients, whose insights fuel our science-based advancements. Visionaries like you work on teams that save lives by developing the medicines of tomorrow.

Join us in developing treatments, finding cures, and pioneering the path from lab to life while championing patients every step of the way.

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 that will include the San Francisco, North Bay, Mendocino & Antioch, CA territories.

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.

An important aspect of patient's 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 of this role includes :

  • Educating 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.
  • Collaborating with field support team members such as sales representatives and key account managers and serving as reimbursement expert for the local team.
  • Acting with a sense of urgency to address critical access and affordability issues for patients.
  • Partnering with managed care colleagues to understand current policies and potential future changes.
  • Conducting field-based reimbursement and access support, education, and creative problem-solving aligned to FRM Rules of Engagement.
  • Building strong, trust-based relationships with customers in all assigned Immunology accounts.
  • Managing territory logistics, routing, and account business planning.
  • Maintaining and growing knowledge of national, regional, local, and account market dynamics including coverage and coding requirements.
  • Growing the knowledge of hub and specialty distribution channels to improve practice and patient support needs.
  • Collaborating with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serving 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).
  • Executing business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training.

Market Access Expertise :

  • Extensive knowledge of medication access channels (i.e., pharmacy and medical benefits 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.

    • Qualifications : Required :

  • 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 hospital and / or provider office setting, building strong customer relationship.
  • Demonstrated expertise with both pharmacy and medical / buy & bill benefits (as applicable), 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.
  • 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.

    • Preferred :

  • 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 salesforce.com CRM use, Microsoft Word, and Excel.

    • Johnson & Johnson is an 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, disability, protected veteran status or other characteristics protected by federal, state or local law. We actively seek qualified candidates who are protected veterans and individuals with disabilities as defined under VEVRAA and Section 503 of the Rehabilitation Act.

    Johnson & Johnson is committed to providing an interview process that is inclusive of our applicants' needs. If you are an individual with a disability and would like to request an accommodation, please contact us via https : / / www.jnj.com / contact-us / careers or contact AskGS to be directed to your accommodation resource.

    The anticipated base pay range for this position is : $100,000 - 172,500

    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 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.

    Subject to the terms of their respective plans, employees are eligible to participate in 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

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    Field Reimbursement Manager • San Francisco, CA, US