Johnson & Johnson MedTech · 21 hours ago
Field Reimbursement Manager Immunology - GI (Milwaukee, WI)
Green Bay, WI
Full-time
Onsite
Senior Level
5+ years expJohnson & Johnson MedTech is a leader in healthcare innovation, dedicated to improving health outcomes through advanced treatments and solutions. The Field Reimbursement Manager Immunology - GI will serve as the primary field-based lead for educating healthcare providers about patient access to J&J Immunology therapies, addressing challenges related to treatment fulfillment and adherence. This role involves significant collaboration with various stakeholders to enhance patient experiences and ensure successful treatment journeys.
Hospital & Health Care
Responsibilities
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
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
Qualification
Required
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 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 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
Preferred
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 salesforce.com CRM use, Microsoft Word, and Excel
Company
Johnson & Johnson MedTech
At Johnson & Johnson MedTech, we are working to solve the world’s most pressing healthcare challenges through innovations at the intersection of biology and technology.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Mike Walker
CFO & VP of Finance DePuy Synthes
Tino Schweighoefer, MBA
CFO Monarch Platform
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