Field Reimbursement Manager, Dermatology

• Serve as the primary field-based lead for education, assistance, and issue resolution concerning patient access to J&J Immunology therapies
• Spend up to 50% of time on-site with healthcare providers, assess education needs, and facilitate stakeholder collaboration
• Educate healthcare providers and office staff on product coverage, prior authorizations, appeals, reimbursement processes, claims submissions, procedures, and payer coding requirements
• Collaborate with sales representatives and key account managers as the local reimbursement expert
• Address critical patient access and affordability issues with urgency
• Partner with managed care colleagues on current policies and potential changes
• Conduct field-based reimbursement and access support, education, and creative problem-solving
• Build trust-based relationships with customers across assigned Immunology accounts
• Manage territory logistics, routing, and account business planning
• Maintain knowledge of market dynamics, coverage, and coding requirements
• Develop knowledge of hub and specialty distribution channels
• Collaborate with internal J&J departments including marketing, sales, medical science, SCG, IBG, HCC, and PECS
• Serve as subject matter expert on access and affordability solutions across Medicare, Medicaid Managed Care, Commercial, and other payer types
• Execute business according to ethical, legal, and compliance standards and complete required training
• Anticipate changes in product coverage, access knowledge, marketplace conditions, and stakeholder practices
• Adapt resourcing and messaging to healthcare providers and staff

• Bachelor’s degree, preferably in healthcare or business/public administration
• Minimum of 5 years of relevant professional experience
• Account Management and/or Reimbursement experience in hospital and/or provider office settings
• Demonstrated expertise with pharmacy and medical/buy & bill benefits, coding, and billing
• Reimbursement or relevant managed care experience, including revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes
• Experience working with patient support HUB services
• Ability to establish relationships, collaborate, and influence across a matrix organization
• Problem-solving ability to navigate challenging access scenarios
• Valid US driver’s license and driving record compliant with company standards
• Ability to maintain up to 50% travel
• Permanent residence in the listed territory
• Preferred:
  Immunology disease state experience
• Preferred:
  Advanced degree and/or relevant certifications in prior authorization and/or billing and coding
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products
• Preferred:
  Technical knowledge and expertise in payer policy, including coding, coverage, and payment
• Demonstrated competence with  CRM, Microsoft Word, and Excel

Demonstrates expertise in patient access and reimbursement processes, including prior authorization, coding, and appeals. Builds strong relationships with healthcare providers while navigating complex managed care environments and ensuring compliance with industry standards.

• Patient Access Expertise
• Reimbursement Processes
• Account Management
• Collaboration Across Matrix Organizations
• Problem-Solving Ability

• Prior Authorization
• Coding
• Billing
• Revenue Cycle Management
• Pharmacy Benefits
• Medical Benefits
• Buy-and-Bill
• Patient Support HUB Services
• Immunology Disease State Knowledge
• Market Dynamics Understanding

• Relationship Building
• Collaboration
• Influencing Skills
• Creative Problem-Solving

• Relevant Certifications in Prior Authorization
• Billing and Coding Certifications

• Medicare
• Medicaid
• Managed Care
• Payer Policy
• Pharmaceutical Reimbursement
• Biotechnology Products

• CRM
• Microsoft Word
• Microsoft Excel