Field Reimbursement Manager

Field Reimbursement ManagerAt Johnson & Johnson Innovative Medicine (JJIM), what matters most is helping people live full and healthy lives. We focus on treating, curing, and preventing some of the most devastating and complex diseases of our time. And we pursue the most promising science, wherever it might be found.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. This is a field-based position and the territory includes Cincinnati and Dayton, OH.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.Job DescriptionAn 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 LifeEvery 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 ResponsibilitiesPrimary 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 teamAct with a sense of urgency to address critical access and affordability issues for patientsPartner with managed care colleagues to understand current policies and potential future changesConduct field-based reimbursement and access support, education and creative problem-solving aligned to FRM Rules of EngagementBuild strong, trust-based relationships with customers in all assigned Immunology accountsManage territory logistics, routing, and account business planningMaintain and grow knowledge of national, regional, local, and account market dynamics including coverage and coding requirementsGrow the knowledge of hub and specialty distribution channels to improve practice and patient support needsCollaborate 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 trainingMarket Access ExpertiseExtensive knowledge of medication access channels (i.e., pharmacy and medical benefit including buy & bill and/or assignment of benefit (AOB) across multiple sites of careRemains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materialsUnderstands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staffQualificationsRequired 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 experienceAccount Management and/or Reimbursement experience working in the provider office setting, building strong customer relationshipDemonstrated expertise with both pharmacy and medical/buy & bill benefits, coding, and billingReimbursement 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 organizationProblem-solving ability to navigate challenging access scenarios and identifies solutions in a timely and efficient mannerSuperior communication skills (written and verbal) and efficient follow-throughExperience in working with patient support HUB servicesValid US driver's license and a driving record in compliance with company standardsAbility to consistently maintain up to 50% travelPermanent residence in the listed territoryPreferred Qualifications:Immunology disease state experienceAdvanced degree and/or relevant certifications in prior authorization and/or billing and codingStrong market access acumen as it relates to payer approval processes and business acumenUnderstanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology productsExcellent technical knowledge and expertise in payer policy, including all elements of reimbursement (coding, coverage, and payment) is preferredDemonstrated competence with salesforce.com CRM use, Microsoft Word, and ExcelDemonstrated commitment to learning emerging technologies, such as AI, through exploration, iteration, and apply new tools over time preferred