Field Reimbursement Manager (Oncology)– (St. Louis, Missouri)

At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity. Learn more at jnj.com

As guided by Our Credo, Johnson & Johnson is responsible to our employees who work with us throughout the world.  We provide an inclusive work environment where each person is considered as an individual.  At Johnson & Johnson, we respect the diversity and dignity of our employees and recognize their merit.

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 Medicine’s 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 Life

Every patient’s 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

Bachelor’s 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 driver’s 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

Johnson & Johnson is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status or other characteristics protected by federal, state or local law. We actively seek qualified candidates who are protected veterans and individuals with disabilities as defined under VEVRAA and Section 503 of the Rehabilitation Act.

Johnson and Johnson is committed to providing an interview process that is inclusive of our applicants’ needs. If you are an individual with a disability and would like to request an accommodation, please email the Employee Health Support Center (ra-employeehealthsup@its.jnj.com) or contact AskGS to be directed to your accommodation resource.

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 Company’s consolidated retirement plan (pension) and savings plan (401(k)).

This position is eligible to participate in the Company’s 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 – 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 period10 days

Volunteer Leave – 32 hours per calendar year

Military Spouse Time-Off – 80 hours per calendar year