Field Reimbursement Manager GI Orange County, CA

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

As guided by Our Credo Johnson & Johnson is responsible to our employees who work with us throughout the world. We provide an inclusive work environment where each person is considered as an individual. At Johnson & Johnson we respect the diversity and dignity of our employees and recognize their merit.

Job Function:

Market Access

Job Sub Function:

Reimbursement

Job Category:

Professional

All Job Posting Locations:

Anaheim California United States Huntington Beach California United States of America Irvine California United States of America Long Beach California United States Santa Ana California United States of America

Job Description:

About Innovative Medicine

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.

Learn more at 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 Medicines 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 Orange County CA.

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 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 patients 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

Market Access Expertise:

• 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

QUALIFICATIONS

Required Qualifications:

• Bachelors 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 drivers 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 Qualifications:

• 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
• Demonstrated commitment to learning emerging technologies such as AI through exploration iteration and apply new tools over time preferred

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 or contact AskGS to be directed to your accommodation resource.

Required Skills:

Preferred Skills:

Account Management Coaching Competitive Landscape Analysis Compliance Management Consulting Cross-Functional Collaboration Escalation Management Fact-Based Decision Making Finance and Accounting Platforms Financial Reports Market Access Reimbursement Market Opportunity Assessment Performance Measurement Pricing Strategies Process Improvements Strategic Thinking Technical Credibility

The anticipated base pay range for this position is :

$105000.00 - $181700.00

Additional Description for Pay Transparency:

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 Colorado 48 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

Bereavement Leave 240 hours for an immediate family member: 40 hours for an extended family member per calendar year

Caregiver Leave 80 hours in a 52-week rolling period10 days

Volunteer Leave 32 hours per calendar year

Military Spouse Time-Off 80 hours per calendar year

For additional general information on Company benefits please go to: Experience:

Manager