Remote Case Reviewer Jobs in Raleigh, NC (NOW HIRING)

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We are searching for the best talent for a Field Liaison to be located in Pittsburgh, PA; Raleigh, NC; Charlotte, NC, Orlando, FL; Phoenix, AZ, Dallas, TX or Horsham, PA.

Purpose:

The Field Liaison is a non-promotional, operations-focused role within the Patient Service Center (PSC). This position serves as the primary operational link between internal case management teams and the Field Reimbursement organization, partnering closely with Field Reimbursement Managers (FRMs) and Associate Directors (FRADs). This role ensures coordination on complex patient access cases, translates field-identified barriers into potential process improvements, and provides the field reimbursement team with clear, timely visibility into PSC workflows. The Field Liaison operates in full compliance with applicable regulations and internal policies.

Responsibilities:

Field Reimbursement Partnership

• Serve as the designated Patient Service Center (PSC) Operations point of contact for assigned Field Reimbursement team members, ensuring consistent communication on patient access cases, access trends, and PSC operational updates.

• Participate in regular business reviews, pipeline calls, and regional FRM/FRAD meetings to discuss access trends, payer changes, and field-identified barriers; translate insights into PSC action plans.

• Clearly communicate PSC services, workflows, SLAs, escalation paths, and documentation expectations with HCP offices and patients.

• Compile and share PSC performance data (e.g., benefit investigations, time-to-therapy, prior authorization turnaround, rejection and denial trends, appeal outcomes) to support field strategies and account planning.

• Maintain structured feedback loops and accurate documentation of interactions, escalations, and resolutions in CRM and PSC case management platforms.

Case Escalation & Access Resolution

• Triage & coordinate resolution of complex access and reimbursement issues raised by the Field Reimbursement partners.

• Troubleshoot patient and account specific reimbursement challenges and assistance programs.

• Coordinate high-priority escalations with clear routing, tracking, and timely resolution updates.

• Identify field-reported access barriers (e.g., prior authorization criteria shifts, denial rationale patterns, site-of-care challenges, affordability issues) and partner with PSC Operations leadership on process improvements.

Operational Alignment & Program Execution

• Support implementation of new patient access programs, payer policy updates, and field reimbursement playbooks by ensuring team readiness.

• Partner on launch readiness and major initiative by identifying process gaps and recommending enhancements.

• Contribute to the development and refinement of PSC reporting and dashboards used by FRADs, ensuring data relevance (case status views, turnaround times, denial categories, SLA adherence) and accessibility.

Compliance, Documentation & Quality

• Ensure all communications and materials align with non-promotional requirements and compliance standards.

• Operate in adherence with HIPAA, OIG, and other applicable regulations; escalate compliance concerns promptly.

Other

• Primarily remote role with periodic travel (approximately 10-30%) for Field Reimbursement regional meetings, business reviews, cross-functional workshops, and training delivery.

• Other Duties as assigned.
  

Required Qualifications:

• Bachelor's degree required - preferably in healthcare, life sciences, pharmacy, or business administration.

• A minimum of 3 years' experience in pharmaceutical or biotech operations, patient services, field reimbursement support, payer relations, or a closely related function.

• Experience partnering with or supporting Field Reimbursement Managers, Field Reimbursement Associate Directors, Market Access, or Patient Support Services teams.

• Clear, confident communicator with strong presentation skills. Highly organized, adaptable, and effective in managing multiple escalations.

Preferred Qualifications:

• Master's degree

• Strong understanding of specialty reimbursement processes (benefit verification, PA, appeals, coding, financial assistance).

• Proven ability to manage cross-functional relationships without direct authority.

• Background in specialty product access, particularly in immunology, oncology, or rare disease programs, is a plus.

• Proficiency with CRM, case management systems, and Microsoft Office tools.

• This is a non-promotional role; all field interactions must remain within compliant, operationally focused boundaries.

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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.