Field Reimbursement Manager – Neuroscience

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

📋 Description

• Act as the main field-based leader for education, support, and problem-solving related to patient access for J&J Neuroscience therapies.

• Allocate up to 50% of time onsite with healthcare providers and their staff.

• Provide education to healthcare professionals about reimbursement procedures, claims submissions, and payer coding requirements.

• Collaborate with sales representatives, key account managers, and other members of the field support team.

• Function as the local team's expert on access, fulfillment, and reimbursement.

• Lead discussions focused on compliant access and fulfillment.

• Leverage data and account management skills to proactively tackle access obstacles.

• Address important patient access and affordability challenges with urgency and accountability.

• Work in partnership with managed care colleagues to stay updated on current policies and potential future modifications.

• Provide field-based reimbursement and access support, education, and innovative problem-solving.

• Establish trust-based relationships with customers in designated accounts.

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

• Stay informed about national, regional, local, and account market dynamics, including coverage and coding requirements.

• Enhance understanding of hub and specialty distribution channels.

• Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS.

• Act as a subject matter expert on access and affordability solutions across Medicare, Medicaid Managed Care, Commercial, and other payer types.

• Conduct business activities in compliance with ethical, legal, and compliance standards as well as required training.

⛳️ Requirements

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

• A minimum of 5 years of relevant professional experience is necessary.

• Experience in Account Management and/or Reimbursement within a provider office setting.

• Proficiency in pharmacy and medical/buy & bill benefit design, coding, billing, prior authorizations, office operations, and appeals procedures.

• Reimbursement or related managed care experience, encompassing revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes.

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

• Strong problem-solving skills to navigate complex access situations and develop timely, efficient solutions.

• Exceptional written and verbal communication abilities along with effective follow-through.

• Experience with patient support HUB services is preferred.

• Valid US driver's license and a driving record that complies with company standards.

• Must have a permanent residence in the specified territory.

• Deep understanding of medication access channels, including pharmacy and medical benefits, buy & bill, and assignment of benefit (AOB).

• Proficient in analyzing complex quantitative and qualitative data.

• Possess critical thinking skills and a desire for intellectual curiosity.

• Ability to stay current on and anticipate changes in product coverage, access knowledge, marketplace dynamics, and stakeholder practices.

• Adaptability to the evolving healthcare environment and capability to customize resources and messaging for healthcare professionals and their staff.

• An advanced business degree (MBA) or a public health degree (MPH) is preferred.

• Experience with neuroscience disease states is a plus.

• Advanced degrees and/or relevant certifications in prior authorization and/or billing and coding are preferred.

• Familiarity with Medicare, Medicaid, and private payer initiatives impacting pharmaceutical and biotechnology reimbursement is preferred.

• Experience with Salesforce.com CRM, Microsoft Word, and Excel is desirable.

• Willingness to engage with emerging technologies such as AI.

• Ability to travel up to 75% of the time is required.

🏝️ Benefits

• 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; 48 hours for employees residing in Colorado; 56 hours for employees residing in Washington.

• 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 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.