Field Reimbursement Manager Immunology GI- Upper Manhattan
Johnson & Johnson, New York, NY, United States
Job Description
Field Reimbursement Manager (FRM) will be a field‑based lead responsible for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff for access to J&J Immunology therapies. The position requires up to 50% on‑site time with HCPs, assessing educational needs and facilitating collaboration with stakeholders.
Primary Responsibilities
Primary responsibilities include the following. Other duties may be assigned.
Educate HCPs on product coverage, prior authorizations, appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations.
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 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, serving as subject‑matter expert regarding 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 including buy & bill and/or assignment of benefit (AOB) across multiple sites of care.
Remain current on and anticipate changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
Understand and adapt to changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.
Required 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 experience.
Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationships.
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 and identify solutions in a timely and efficient manner.
Superior communication skills (written and verbal) and efficient follow‑through.
Experience working with patient support HUB services.
Valid U.S. driver’s license and a compliant driving record.
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 relative 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 coding, coverage, and payment.
Demonstrated competence with Salesforce.com CRM, Microsoft Word, and Excel.
Pay & Benefits
Base pay range: $102,000.00 – $177,100.00.
Eligible to participate in the company’s long‑term incentive program.
Participates in the consolidated retirement plan (401(k)).
Vacation: 120 hours per calendar year.
Sick time: 40 hours per calendar year (48 hours for Colorado residents, 56 hours for Washington residents).
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 birth/adoption/foster care.
Bereavement leave: 240 hours for immediate family, 40 hours for extended family per year.
Caregiver leave: 80 hours in a 52‑week rolling period.
Volunteer leave: 32 hours per calendar year.
Military spouse time‑off: 80 hours per calendar year.
Equal Opportunity Employer
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 inclusive interview process. If you have a disability and would like to request accommodation, contact us at https://www.jnj.com/contact-us/careers or AskGS to be directed to your accommodation resource.
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Field Reimbursement Manager (FRM) will be a field‑based lead responsible for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff for access to J&J Immunology therapies. The position requires up to 50% on‑site time with HCPs, assessing educational needs and facilitating collaboration with stakeholders.
Primary Responsibilities
Primary responsibilities include the following. Other duties may be assigned.
Educate HCPs on product coverage, prior authorizations, appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations.
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 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, serving as subject‑matter expert regarding 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 including buy & bill and/or assignment of benefit (AOB) across multiple sites of care.
Remain current on and anticipate changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
Understand and adapt to changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.
Required 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 experience.
Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationships.
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 and identify solutions in a timely and efficient manner.
Superior communication skills (written and verbal) and efficient follow‑through.
Experience working with patient support HUB services.
Valid U.S. driver’s license and a compliant driving record.
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 relative 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 coding, coverage, and payment.
Demonstrated competence with Salesforce.com CRM, Microsoft Word, and Excel.
Pay & Benefits
Base pay range: $102,000.00 – $177,100.00.
Eligible to participate in the company’s long‑term incentive program.
Participates in the consolidated retirement plan (401(k)).
Vacation: 120 hours per calendar year.
Sick time: 40 hours per calendar year (48 hours for Colorado residents, 56 hours for Washington residents).
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 birth/adoption/foster care.
Bereavement leave: 240 hours for immediate family, 40 hours for extended family per year.
Caregiver leave: 80 hours in a 52‑week rolling period.
Volunteer leave: 32 hours per calendar year.
Military spouse time‑off: 80 hours per calendar year.
Equal Opportunity Employer
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 inclusive interview process. If you have a disability and would like to request accommodation, contact us at https://www.jnj.com/contact-us/careers or AskGS to be directed to your accommodation resource.
#J-18808-Ljbffr