National Field Reimbursement Manager, Neuroscience (Corporate Accounts) – (National) – Patient Engagement & Customer Solutions (PECS)) – Patient Engagement & Customer Solutions (PECS)

Johnson & Johnson Innovative Medicine develops healthcare solutions focused on treating, curing, and preventing complex diseases. The National Field Reimbursement Manager supports corporate accounts by leading education, access, reimbursement, and issue-resolution activities for neuroscience therapies, while collaborating with healthcare providers, customers, internal teams, and payer stakeholders.

Responsibilities:

• Gain a deep understanding of corporate access and reimbursement processes, objectives, and challenges and then translating this knowledge into developing strategic plans
• Educate stakeholders on reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.)
• Effectively collaborate with field support team members such as key account managers and field reimbursement managers across the nation and serve as access, fulfillment, and reimbursement expert for account
• Lead compliant access and fulfillment discussions with field support team members
• Utilize data and account management skills to proactively address access barriers
• Act with a sense of urgency and accountability 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 accounts
• Manage account engagement logistics, routing, and 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

Requirements:

• • Extensive knowledge of medication access channels (i.e., pharmacy and medical benefit including buy & bill and/or assignment of benefit (AOB))
• • Demonstrates critical thinking
• • Ability to analyze highly complex, quantitative and qualitative data to accelerate speed to access
• • Ambitious and possess a high degree of intellectual curiosity
• • Excellent social, communication, facilitation and presentation skills required
• • 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, HCP 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 working in the provider office setting, building strong customer relationship
• • Demonstrated expertise with both pharmacy and medical/buy & bill benefit design, coding, billing, prior authorizations, office operations, and appeals processes
• • 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 and can travel up to 50%
• An advanced business degree (MBA), or public health (MPH)) is preferred
• • Neuroscience 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