Field Reimbursement Manager, Rheumatology

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

📋 Description

• Act as the primary field-based leader for education, support, and resolution of issues related to patient access for J&J Immunology therapies.

• Allocate up to 50% of your time on-site with healthcare providers to evaluate educational needs and foster collaboration among stakeholders.

• Provide education to healthcare providers and office personnel regarding product coverage, prior authorizations and appeals, reimbursement procedures, claims submissions, and payer coding requirements.

• Work in tandem with sales representatives and key account managers as the reimbursement authority for the local team.

• Tackle critical patient access and affordability challenges with promptness and urgency.

• Collaborate with managed care colleagues to gain insights into current policies and potential future modifications.

• Deliver field-based reimbursement and access support, education, and innovative problem-solving in line with FRM Rules of Engagement.

• Establish strong, trust-based relationships with clients within assigned Immunology accounts.

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

• Continuously enhance knowledge of market dynamics, coverage, and coding requirements.

• Expand understanding of hub and specialty distribution channels to enhance practice and patient support.

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

• Function as a subject matter expert regarding access and affordability solutions across various payer types, including Medicare, Medicaid Managed Care, and Commercial.

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

• Stay updated on product coverage, access knowledge, market conditions, and stakeholder practices.

• Tailor resources and messaging to healthcare providers and staff in response to the evolving healthcare landscape.

⛳️ Requirements

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

• At least 5 years of relevant professional experience.

• Experience in Account Management and/or Reimbursement within hospital and/or provider office settings, fostering strong customer relationships.

• Proven expertise in both pharmacy and medical/buy & bill benefits, including coding and billing.

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

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

• Strong problem-solving skills to navigate complex access scenarios and devise timely, effective solutions.

• Familiarity with patient support HUB services.

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

• Willingness to maintain up to 50% travel consistently.

• Permanent residence within the specified territory.

• Experience in immunology disease states is preferred.

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

• Strong market access and business acumen are preferred.

• Understanding of Medicare, Medicaid, and private payer initiatives impacting reimbursement is preferred.

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

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

• A commitment to learning about emerging technologies, such as AI, is preferred.

🏝️ Benefits

• 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 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 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.