Job Function:
Market Access
Job Sub Function:
Reimbursement
Job Category:
Professional
All Job Posting Locations:
Belleville, Illinois, United States, Cape Girardeau, Missouri, United States, Carbondale, Illinois, United States, Columbia, Missouri, United States, Missouri (Any City), Springfield, Missouri, United States, St. Louis, Missouri, United States
Job Description:
About Oncology
Our expertise in Innovative Medicine is informed and inspired by patients, whose insights fuel our science-based advancements. Visionaries like you work on teams that save lives by developing the medicines of tomorrow.
Our Oncology team is focused on the elimination of cancer by discovering new pathways and modalities to finding treatments and cures. We lead where medicine is going and need innovators with an unwavering commitment to results.
Join us in developing treatments, finding cures, and pioneering the path from lab to life while championing patients every step of the way.
Learn more at https://www.jnj.com/innovative-medicine
Johnson & Johnson Innovative Medicine9s Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager for the Great Plains territory which is a field-based position. The Local FRM team is aligned to community hospitals, independent Oncology clinics, and small Oncology group practices. The St. Louis, Missouri territory includes of Eastern Missouri and Southern Illinois
PECS is committed to setting the standard on Patient Experience (Px), building more personalized, seamless, and supportive experiences to help patients start and stay on treatments across the portfolio.
Job Description:An important aspect of patient unmet need includes helping them start and stay on their medicine for the best chance at treatment success. The Patient Engagement and Customer Solutions (PECS) organization serves patients, during their treatment journey with Janssen therapies, to help overcome challenges to fulfillment, on-boarding, and adherence.
The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Oncology therapies. This role involves investing time (up to 50%) on-site with HCPs, assessing their education needs and facilitating collaboration with various stakeholders.
A Day in the LifeEvery patient9s healthcare experience is unique - shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, the decision to start or stop a treatment is overwhelming. J&J recognizes this, and wants to create an experience that is personalized, helpful, and hopeful.
Primary Responsibilities: Primary responsibilities include the following. Other duties may be assigned.
- Educate HCPs on 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 Oncology 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
Market Access Expertise:- 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
Qualifications:REQUIRED
- Bachelor9s 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 driver9s 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- Oncology 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
- Demonstrated commitment to learning emerging technologies, such as AI, through exploration, iteration, and apply new tools over time preferred
Required Skills:
Preferred Skills:
Account Management, Coaching, Competitive Landscape Analysis, Compliance Management, Consulting, Cross-Functional Collaboration, Escalation Management, Fact-Based Decision Making, Finance and Accounting Platforms, Financial Reports, Market Access Reimbursement, Market Opportunity Assessment, Performance Measurement, Pricing Strategies, Process Improvements, Strategic Thinking, Technical Credibility
The anticipated base pay range for this position is :
$102,000.00 - $177,100.00
Additional Description for Pay Transparency:
Subject to the terms of their respective plans, employees are eligible to participate in the Company9s consolidated retirement plan (pension) and savings plan (401(k)).
This position is eligible to participate in the Company9s long-term incentive program.
Subject to the terms of their respective policies and date of hire, employees are eligible for the following time off benefits:
Vacation 120 hours per calendar year
Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado 48 hours per calendar year; for employees who reside in the State of Washington 56 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 180 hours within one year of the birth/adoption/foster care of a child
Bereavement Leave 60 hours for an immediate family member: 40 hours for an extended family member per calendar year
Caregiver Leave 20 hours in a 52-week rolling period10 days
Volunteer Leave 6 hours per calendar year
Military Spouse Time-Off 20 hours per calendar year
