Job Closed
This listing is no longer active.
Field Reimbursement Manager – Pulmonary Hypertension
Location
United States
Posted
91 days ago
Salary
$102K - $177.1K / year
Seniority
Senior
Job Description
Field Reimbursement Manager – Pulmonary Hypertension
Johnson & Johnson
• 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 products. • Collaborate with field support team members such as business directors and serve as reimbursement expert. • 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 and virtual 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 PAH 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 EPG marketing, SCG, 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.
Job Requirements
- 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 hospital and/or provider office setting, building strong customer relationship.
- Demonstrated expertise with pharmacy benefits and manufacturer affordability solutions (e.g. co-pay assistance).
- Reimbursement or relevant managed care experience (prior authorization, formulary exception 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.
- 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 20% travel.
- Preferred PAH disease state experience and/or rare disease experience.
- Advanced degree and/or relevant certifications in prior authorization.
- 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 products.
- Excellent technical knowledge and expertise in payer policy.
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
Related Guides
Related Categories
Related Job Pages
More Manager Jobs
Medical Education Manager EMEA
Siemens HealthineersWe pioneer breakthroughs in healthcare. For everyone. Everywhere. Sustainably.
Join us in pioneering breakthroughs in healthcare. For everyone. Everywhere. Sustainably. Our inspiring and caring environment forms a global community that celebrates diversity and individuality. We encourage you to step beyond your comfort zone, offering resources and flexibility to foster your professional and personal growth, all while valuing your unique contributions. Manager of Medical Education, VIS EMEA Responsibilities - Develop and execute educational plans and tactics for EMEA including monitoring and measurement of program effectiveness to achieve stated objectives for the business unit in collaboration with the Director of Medical Education - Manage relationships with external clinical faculty in EMEA - Work with the EMEA cross functional team including marketing, medical, and commercial to better understand the needs of the customers in EMEA - Monitor the EMEA Medical Education budget to make sure that our programs fall within the allocated budget - Establish clear metrics for medical education to be used both internally and externally to understand and replicate best practices and success - Develop and implement best in class training models, in conjunction and collaboration with third parties, possibly including academic and university centers - Leverage medical education colleagues within Varian to gain insight and knowledge into best practices in EMEA across other business units - Continuously explore alternative methods for delivering medical education and new approaches, practices, and processes to improve the efficiency and effectiveness of training - Work closely and collaboratively with Legal and Regulatory to help ensure Medical Education and meeting materials and practices adhere to corporate guidelines and policies - Ensure Medical Education programs in EMEA reflect the highest standards of conduct and compliance for the Medical Device and Pharmaceutical industries - Comprehensive understanding of VIS products, be a key contributor to VIS by understanding educational needs for each VIS product - Oversee physician contracting in EMEA for educational programs with the help of the Medical Education Specialist, and liaise with VIS EMEA Compliance and Finance teams to ensure all physician payments comply with Varian policies and procedures - Manage speaker selection for educational programs in EMEA - Oversee content review for medical education programs for both internal and external training - Manage topics, content, and speakers for symposium at Congresses in collaboration with marketing Minimum Required Skills and Knowledge: - Provides strong industry experience for project execution - Proactive and self-disciplined, ability to meet deadlines, effective use of time, and prioritization - Proficient in creating and maintaining program/ project plans, budgets, timelines, and resource requirements - Works collaboratively and cross functionally with internal and external business partners - Exceptional planning, organizational, analytical and negotiation skills. - Exceptional Communication skills: communicates with candor around project and program updates and organizational needs. - Proficient in utilizing business tools such as: E-mail, Microsoft Word, Excel, Teams, and PowerPoint. Typical Education and Experience: - A minimum of Bachelor’s degree is required - Several years of related industry experience: Medical education, Training, Project Management #LI-OS1 #LI-REMOTE Who we are: We are a team of more than 72,000 highly dedicated Healthineers in more than 70 countries. As a leader in medical technology, we constantly push the boundaries to create better outcomes and experiences for patients, no matter where they live or what health issues they are facing. Our portfolio is crucial for clinical decision-making and treatment pathways. How we work: When you join Siemens Healthineers, you become one in a global team of scientists, clinicians, developers, researchers, professionals, and skilled specialists, who believe in each individual’s potential to contribute with diverse ideas. We are from different backgrounds, cultures, religions, political and/or sexual orientations, and work together, to fight the world’s most threatening diseases and enable access to care, united by one purpose: to pioneer breakthroughs in healthcare. For everyone. Everywhere. Sustainably. To find out more about Healthineers’ specific businesses, please visit our company page here. As an equal opportunity employer, we welcome applications from individuals with disabilities. Data Privacy: We care about your data privacy and take compliance with GDPR as well as other data protection legislation seriously. For this reason, we ask you not to send us your CV or resume by email. We ask instead that you create a profile where you can upload your CV. Setting up a profile also lets us know you are interested in career opportunities with us and makes it easy for us to send you an alert when relevant positions become open. Register here to get started. Beware of Job Scams: Please beware of potentially fraudulent job postings or suspicious recruiting activity by persons that are currently posing as Siemens Healthineers recruiters/employees. These scammers may attempt to collect your confidential personal or financial information. If you are concerned that an offer of employment with Siemens Healthineers might be a scam or that the recruiter is not legitimate, please verify by searching for the posting on the Siemens Healthineers career site. To all recruitment agencies: Siemens Healthineers does not accept agency resumes. Please do not forward resumes to our jobs alias, employees, or any other company location. Siemens Healthineers is not responsible for any fees related to unsolicited resumes. As an equal opportunity employer, we welcome applications from individuals with disabilities.
p { font-family: Arial !important; font-size: small !important; } li { font-family: Arial !important; font-size: small !important; } span { font-family: Arial !important; font-size: small !important; } .div-header-left { display: inline-block; vertical-align: top; width: 19%; } .div-header-right { display: inline-block; vertical-align: top; width: 9%; } .div-header-middle { text-align: center; width: 70%; vertical-align: top; padding-top: 5px; display: inline-block; } @media (max-width: 768px) { .div-header-middle { text-align: center; width: 70%; vertical-align: top; padding-top: 0px; display: inline-block; } p { font-family: Arial !important; font-size: x-small !important; } li { font-family: Arial !important; font-size: x-small !important; } span { font-family: Arial !important; font-size: x-small !important; } } hr { border: 1px solid #E36C09; margin: auto } Terrial recrute un (une) Responsable Commercial Régional Secteur Quart Nord Ouest de la France. Poste en Home office. Permanent contract Intégrer TERRIAL, c’est s’engager dans l’agriculture moderne et durable en proposant une gamme de produits écologiques pour fertiliser le sol et nourrir les plantes. Rejoignez TERRIAL, filiale des groupes Avril et Suez, leader du marché des engrais et amendements organiques en France ! Nous assurons la mise en marché et la valorisation des co-produits industriels et urbains pour une agriculture éco-responsable. Nos solutions optimisent les ressources de la terre, entretiennent la fertilité naturelle des sols et contribuent à des récoltes de qualité afin de limiter l’utilisation de produits phyto-pharmaceutiques. Nous agissons chaque jour pour des productions végétales durables et respectueuses de l’environnement. Nous nous engageons auprès de la distribution pour répondre aux enjeux environnementaux vers une nouvelle agriculture. Quels seront les enjeux du poste et votre contribution ? Terrial recrute pour accompagner son développement et répondre à ses ambitions. Notre poste de Responsable commercial régional vous attend ! Dans un contexte de fort développement, vous serez responsable de la performance commerciale globale de la zone géographique. Votre quotidien et vos missions clés seront : => Développement commercial : · Définir, faire valider le budget de sa région et le construire pour ses équipes · Assurer la performance économique et commerciale des différents marchés du périmètre · Etre garant du recouvrement de la clientèle du secteur (collaborateurs compris) · Faire appliquer la politique et la stratégie commerciale de l’entreprise · Participer à la mise en place d’indicateurs de performance, à leur suivi, leur analyse et à la mise en place d’actions correctives · Assurer la relation achats avec les clients grands comptes et transmet les consignes d’animation qui en découlent à ses équipes · Etre responsable des engagements contractuels avec les plateformes de compostages du secteur et autres partenaires · Consolider la veille concurrentielle de son secteur => Mangement et support : · Animer les ressources placées sous votre responsabilité de manager consistant en une proximité très forte par le biais d’accompagnements réguliers, d’entretiens formalisés, du suivi des tableaux de bords, et de la mise en œuvre et du suivi des plans d’actions qui en découlent · Etre garant du bon déroulement de développement de gammes sur son secteur ainsi que de leurs animations par ses équipes · En lien fonctionnel avec le Directeur des Opérations et ses équipes, s’engager à prendre en considération les contraintes de transport, de logistique et d’ordonnancement · Etre pro-actif et porter la politique sécurité de l’entreprise auprès de ses collaborateurs et clients Dès votre arrivée, un parcours d’intégration est prévu pour vous accompagner dans votre prise de fonction. Pourquoi vous ? - Vous êtes issu (e) d’une formation supérieure (ingénieur-master…) et maitrisez les bases agronomiques et les codes de la distribution agricole - Vous êtes un(e) excellent(e) communicant(e) et faites preuve de flexibilité. - Autonomie, rigueur, esprit d’équipe, sens de l’organisation et du service, réactivité et diplomatie : voilà les qualités essentielles pour réussir dans votre mission. Enfin, doté(e) d’une appétence forte pour le monde agricole, vous avez la réelle ambition de grandir et d'évoluer. Au-delà des compétences, votre personnalité et votre motivation feront également la différence ! Pourquoi choisir Terrial ? Chez Terrial : - Votre sécurité et votre santé seront notre priorité n°1 Vos avantages : - Rémunération attractive + prime + voiture de fonction + avantages société Chez Terrial, nous sommes convaincus que vos individualités constituent la richesse de notre entreprise. Terrial s’engage à construire un environnement inclusif de toutes les diversités. Nous assurons l’égalité des chances dans nos processus de recrutement et d’intégration et veillons à ce que vous puissiez être vous-même dans votre environnement professionnel.
CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Idaho. Work from home, and on the road. Monday – Friday, regular business hours. As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source - Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans - Provides assessment, planning, implementation, and evaluation of patient’s progress - Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness - Attends doctors, other providers, home and in some cases, attorney’s visits - Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy - Conducts home visit for initial evaluation - Implements care such as negotiating the delivery of durable medical equipment and nursing services - This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month - This role may require overnight travel - Additional duties as required KNOWLEDGE & SKILLS: - Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment - Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers - A cost containment background, such as utilization review or managed care is helpful - Strong interpersonal, time management, and organizational skills - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets - Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: - Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred - Graduate of accredited school of nursing - Current RN Licensure in state of operation - Certification as a CCM, CIRS, or other Case Management certifications preferred - A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $63,739 – $95,264 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL – Medical Case Managers: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
Medical Case Manager
Crawford & CompanyWe’re Crawford, a global leader in claims management, where every claim represents a person and a community we help restore. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values.
To provide effective case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and CMSA Standards of Practice and Broadspire Quality Assurance (QA) Guidelines to patients/employees who are receiving benefits under an Insurance Line including but not limited to Workers' Compensation, Group Health, Liability, Disability, and Care Management. Why Crawford? Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com. When you accept a job with Crawford, you become a part of the One Crawford family. Our total compensation plans provide each of our employees with far more than just a great salary - Pay and incentive plans that recognize performance excellence - Benefit programs that empower financial, physical, and mental wellness - Training programs that promote continuous learning and career progression while enhancing job performance - Sustainability programs that give back to the communities in which we live and work - A culture of respect, collaboration, entrepreneurial spirit and inclusion Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.


