Field Reimbursement Specialist

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:

Customer Management

Job Sub Function:

Customer Service Operations

Job Category:

Professional

All Job Posting Locations:

Guaynabo, Puerto Rico, United States of America

Job Description:

Johnson & Johnson is currently recruiting for a Field Reimbursement Specialist to be based in Puerto Rico.

About Innovative Medicine  

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. 

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 

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 Access Specialist (FRAS) 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 Immunology 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 product coverage, prior authorizations and appeals, 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 specialists 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 FRAS Rules of Engagement.
• Build strong, trust-based relationships with customers in all assigned Immunology 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,  HCC, and PECS.  Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans pertaining Puerto Rico’s access dynamics (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:

• 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.
• Deep understanding of Puerto Rico’s access & reimbursement ecosystem.
• 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.

Requirements:

• Bachelor’s degree (preferably in healthcare or business).  
• Minimum of 2-3 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.
• Excellent communication skills (written and verbal) and efficient follow-through.
• Experience in working with patient support HUB services.
• Valid Puerto Rico driver’s license and a driving record in compliance with company standards.
• Ability to consistently maintain up to 75% travel.
• Flexibility in territory geographical coverage with preference for home base in the Metro, North or West area or PR.

Preferred:

• Immunology disease state experience.
• Advanced degree and/or relevant certifications in prior authorization and/or billing and coding.
• 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.
• Good 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.

Other Requirements:

• Bilingual (English/Spanish).
• Must be able to travel overnight and/or weekend as required or needed. (PR & US based meetings and conventions).
• Position requires frequent travel and some field contact with sales representatives.

*Position eligible for company vehicle due to travel requirements

If you are under 18 years of age, you (the candidate) may need to obtain the necessary working papers or other documentation required by state law to start the assignment, as well as get a parent’s consent for the background check.

 

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 & 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, external applicants please contact us via https://www.jnj.com/contact-us/careers , internal employees contact AskGS to be directed to your accommodation resource.

 

 

Required Skills:

 

 

Preferred Skills: