Manager, Reimbursement and Payment Policy

Johnson Johnson; Florida; Hybrid; USD 130,000 - 180,000; Full time

Job summary

Johnson & Johnson is seeking a Manager, Reimbursement and Payment Policy to join our Orthopaedics team. The role will focus on delivering robust reimbursement support and policy monitoring across CMS systems. Ideally located in Palm Beach Gardens, FL, Raynham, MA, Warsaw, IN, Washington, D.C.

or West Chester, PA, with remote work options on a case-by-case basis and with company approval. This role is designed for a professional with 5-10 years of experience in coding, coverage, and payment

Qualifications

• 5-10 years of professional experience in coding, coverage, and payment policy within the MedTech sector.

Responsibilities

• CMS Payment Policy Support: develop and execute payment policy strategy for Orthopaedics across Medicare payment systems, including IPPS/MS-DRGs, OPPS/ASC, and the Physician Fee Schedule.
• Policy Monitoring & Analysis: monitor CMS proposed and final rules, Medicaid and commercial payer policy updates, and summarize implications for internal stakeholders.
• Reimbursement Hotline & Vendor Management: manage the Orthopaedics Reimbursement Hotline, vendor oversight, service levels, and escalation handling.
• Coding Guides, Reimbursement Tools & Field Education: lead updates of coding and reimbursement guides, FAQs, and customer-facing resources.
• External Engagement & Advocacy Support: assist in drafting materials for CMS and stakeholder engagements.

Job description

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:

Palm Beach Gardens, Florida, United States of America, Raynham, Massachusetts, United States of America, Remote (US), Warsaw, Indiana, United States of America, Washington, District of Columbia, United States of America, West Chester, Pennsylvania, United States of America

Job Description:

We are searching for the best talent for a Manager, Reimbursement and Payment Policy to join our Orthopaedics team. The role will ideally be located in Palm Beach Gardens, FL, Raynham, MA, Warsaw, IN, Washington, D.C. or West Chester, PA however remote work options may be considered on a case-by-case basis and if approved by the Company.

Purpose:

This role is designed for a professional with 5-10 years of professional experience in coding, coverage, and payment policy within the MedTech sector who can work independently and manage programs and vendors. The Manager will partner with cross-functional teams to deliver reliable reimbursement support, policy monitoring, and field enablement initiatives that drive market access for innovative orthopaedic technologies. This is an individual contributor role with no direct reports.

You will be responsible for:

• CMS Payment Policy Support
  • Support the Director in developing and executing payment policy strategy for the Orthopaedics portfolio across Medicare payment systems, including IPPS/MS-DRGs, OPPS/ASC, and the Physician Fee Schedule.
  • Conduct research and analysis to inform coding, coverage, and payment positioning for both pipeline and in-line products, including DRG, APC, and code assignment questions.
  • Assist in the preparation of reimbursement assessments for new product launches and lifecycle management.
• Policy Monitoring & Analysis
  • Monitor and analyze CMS proposed and final rules, along with Medicaid and commercial payer policy updates, and summarize implications for internal stakeholders.
  • Track changes in DRG, CPT/HCPCS coding, ASC/HOPD payment systems, and emerging reimbursement trends.
  • Develop concise summaries, executive alerts, and briefs that translate policy updates into actionable insights.
  • Manage multiple projects and deadlines tied to the CMS rulemaking calendar and annual coding cycles, and communicate status and risks to leadership.
• Reimbursement Hotline & Vendor Management
  • Own day-to-day management of the Orthopaedics Reimbursement Hotline (phone and email), including vendor oversight, service levels, response quality, and escalation handling.
  • Manage the end-to-end hotline vendor relationship, including performance review and contract and scope management.
  • Ensure hotline operations comply with applicable healthcare compliance, privacy, and company policies, in partnership with Legal, Compliance, and Privacy.
  • Analyze inquiry logs to identify trends in customer needs, coding questions, and payer issues, and report insights and recommendations to HEMA and Commercial leadership.
  • Promote awareness of hotline services with field teams and customers, and set metrics to measure utilization and customer satisfaction.
• Coding Guides, Reimbursement Tools & Field Education
  • Lead the annual update and lifecycle management of coding and reimbursement guides, FAQs, and customer-facing resources across joint reconstruction, trauma, spine, sports medicine, and related portfolios.
  • Ensure all guides reflect current CPT, HCPCS, ICD-10-CM/PCS, MS-DRG, and APC information, as well as CMS payment rates and rule changes, and are accurate, compliant, and timely.
  • Manage the content review and approval process with Legal, Regulatory, and Compliance, and maintain version control and a publication calendar.
  • Design and deliver training for sales, marketing, and customer-facing teams on coding, coverage, and payment, and translate policy updates into practical field guidance.
  • Partner with cross-functional teams to keep reimbursement websites and resource libraries current and easy to navigate.
• External Engagement & Advocacy Support
  • Assist the Director in drafting comment letters and background materials for CMS and other stakeholder engagements.
  • Support preparation fo