Field Reimbursement Manager, Rheumatology (Atlanta, GA) Patient Engagement and Customer Solutions (PECS)
Johnson & Johnson Innovative Medicine
Summary
The Field Reimbursement Manager (FRM) serves as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff regarding patient access to J&J Immunology therapies. This field-based position covers the Atlanta, Georgia territory and involves up to 50% on-site time with HCPs.
Job description
About the Role
The Field Reimbursement Manager (FRM) serves as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff regarding patient access to J&J Immunology therapies. This field-based position covers the Atlanta, Georgia territory and involves up to 50% on-site time with HCPs.
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 (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 (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.
- Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.
Requirements
- Bachelor's degree (preferably in healthcare or business/public administration)
- Minimum of 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 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
- Experience 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
Company overview
Johnson & Johnson Innovative Medicine is the pharmaceutical division of Johnson & Johnson, leading the way in medical innovation with a relentless focus on bringing transformational treatments to patients worldwide. The company applies rigorous science and compassion to address the most complex diseases of our time, developing groundbreaking medicines across key therapeutic areas including oncology, immunology, neuroscience, and cardiopulmonary medicine. With deep expertise and global reach, Johnson & Johnson Innovative Medicine reimagines how devastating diseases are treated and cured, delivering hope and better care for millions of patients and their families. The organization pioneers the path from laboratory research to clinical application, championing patients every step of the way while maintaining an unwavering commitment to scientific excellence and patient-centered innovation.