Field Reimbursement Manager – GI

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Act as the primary on-site lead for education, support, and resolution of issues relating to patient access to J&J Immunology therapies.

• Dedicate up to 50% of time on-site with healthcare providers to evaluate their educational requirements.

• Provide education to healthcare providers concerning product coverage, prior authorizations, appeals, reimbursement processes, claims submissions, and payer coding standards.

• Partner with sales representatives, key account managers, managed care colleagues, and other internal departments of J&J.

• Function as the reimbursement expert for the local team and a subject matter expert on access and affordability solutions.

• Tackle urgent patient access and affordability challenges with a sense of urgency.

• Conduct field-based reimbursement and access support, education, and innovative problem-solving under FRM Rules of Engagement.

• Cultivate trust-based relationships with clients in assigned Immunology accounts.

• Oversee territory logistics, routing, and account business planning.

• Stay informed about market dynamics, coverage, and coding requirements.

• Gain knowledge of hub and specialty distribution channels.

• Perform business operations in accordance with ethical, legal, and compliance standards and complete necessary training.

• Keep current on product coverage, access knowledge, market conditions, and stakeholder practices.

• Tailor resources and messaging for healthcare providers and staff in response to changes in the healthcare ecosystem.

⛳️ Requirements

• Bachelor’s degree, preferably in healthcare or business/public administration.

• A minimum of 5 years of pertinent professional experience.

• Experience in Account Management and/or Reimbursement within the provider office environment.

• Proven expertise with pharmacy and medical/buy & bill benefits, coding, and billing.

• Experience in reimbursement or managed care, including revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes.

• Capability to build relationships, collaborate, and influence within a matrix organization.

• Problem-solving skills to navigate challenging access scenarios and devise solutions.

• Excellent written and verbal communication skills with efficient follow-through.

• Experience with patient support HUB services.

• Valid US driver’s license and a driving record compliant with company standards.

• Ability to consistently maintain up to 50% travel.

• Permanent residence within the specified territory.

• Experience with immunology disease states is preferred.

• An advanced degree and/or relevant certifications in prior authorization and/or billing and coding are preferred.

• Strong market access and business acumen are preferred.

• Understanding of Medicare, Medicaid, and private payer initiatives affecting pharmaceutical and biotechnology product reimbursement.

• Technical knowledge of payer policy, including coding, coverage, and payment is preferred.

• Proficiency in Salesforce.com CRM, Microsoft Word, and Excel.

• Commitment to learning about emerging technologies such as AI is preferred.

🏝️ Benefits

• Company consolidated retirement plan (pension).

• Savings plan (401(k)).

• Long-term incentive program.

• Vacation – 120 hours per calendar year.

• Sick time – 40 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 period.

• Volunteer Leave – 32 hours per calendar year.

• Military Spouse Time-Off – 80 hours per calendar year.

• Inclusive interview process and disability accommodations.