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Field Reimbursement Manager (Immunology Rheumatology) - San Francisco South, CA Johnson & Joh[.[...]

Field Reimbursement Manager (Immunology Rheumatology) - San Francisco South, CA Johnson & Joh[.[...]

Johnson & JohnsonSan Francisco, CA, United States
5 days ago
Job type
  • Permanent
Job description

Field Reimbursement Manager (Immunology Rheumatology)

San Francisco South, CA | Johnson & Johnson HCS, Inc.

Job Function

Market Access

Job Sub Function

Reimbursement

Job Category

People Leader

Locations

San Francisco, CA; San Jose, CA; Salinas, CA; Sunnyvale, CA; San Mateo, CA; Santa Clara, CA

Job Description

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

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.

Primary Responsibilities

  • Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations 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.
  • Execute 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 (pharmacy and medical benefits, buy & bill, 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 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). MBA, MPH is preferred.
  • Minimum 5 years of relevant professional experience.
  • Account Management and / or Reimbursement experience in hospital and / or provider office setting.
  • Demonstrated expertise with pharmacy and medical / buy & bill benefits, coding, and billing.
  • Reimbursement or managed care experience (revenue cycle, buy‑and‑bill, prior authorization, coding, and appeals).
  • Ability to establish relationships, collaborate, and influence across a matrix organization.
  • Problem‑solving ability to navigate challenging access scenarios and deliver solutions efficiently.
  • Experience with patient support HUB services.
  • Valid US driver’s license with a clean driving record.
  • Up to 50% travel required.
  • Permanent residence in the listed territory.

    • Preferred

  • Immunology disease state experience.
  • Advanced degree and / or certifications in prior authorization, billing, and coding.
  • Strong market access acumen related to payer approval processes.
  • Understanding of Medicare, Medicaid, and private payer initiatives.
  • Excellent technical knowledge of payer policy and reimbursement.
  • Proficiency with Salesforce CRM, Microsoft Word, and Excel.

    • Benefits Summary

  • Base pay range : $100,000 to $175,000.
  • Eligible for company car through Fleet program.
  • Medical, dental, vision, life, disability, accident, legal insurance.
  • 401(k) retirement plan.
  • Vacation : 120 hours per year.
  • Sick time : 40 hours per year (56 hours for Washington residents).
  • Holiday pay and floating holidays totaling 13 days.
  • Work, personal and family time up to 40 hours per year.
  • Parental leave : 480 hours within one year of birth / adoption / foster care.
  • Condolence leave 30 days for immediate family; 5 days extended.
  • Caregiver leave 10 days.
  • Volunteer leave 4 days.
  • Military spouse time‑off 80 hours.

    • Legal and Equal Opportunity

    Johnson & Johnson is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, sex, national origin, disability, or veteran status.

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    Field Reimbursement Manager • San Francisco, CA, United States