Field Reimbursement Manager - Kidney (Capitol - WV, VA, MD)
Vertex Pharmaceuticals
June 27, 2026
On-site
United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices to provide non-promotional access and reimbursement education and troubleshoot for timely patient access.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel (care team and prior authorization/patient access staff).
- Partner with case management to address escalated access issues and ensure coordinated handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain knowledge of commercial and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formularies, PA/medical exception criteria, ICD-10/CPT coding, documentation, and distribution/hub/reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need and payer/KPSP demand; develop territory engagement plans.
- Adhere to non-promotional guidelines, legal/compliance/privacy guardrails, and patient confidentiality.
Knowledge, Skills, Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices; navigate payer portals/CRM/access tools.
- Strong communication/training/relationship-building, analytical and data/reporting skills.
- Experience developing/executing strategic business/account plans; sound judgment.
- Travel 50–70%; proficiency: Outlook, Word, Excel, PowerPoint, Salesforce CRM.
- Valid driver’s license; ability to meet credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep PA/appeals/coverage knowledge; payer knowledge including Medicare, Medicaid, and commercial.
Pay Range:
$136,000–$204,000; eligible for annual bonus and annual equity awards.
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices to provide non-promotional access and reimbursement education and troubleshoot for timely patient access.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel (care team and prior authorization/patient access staff).
- Partner with case management to address escalated access issues and ensure coordinated handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain knowledge of commercial and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formularies, PA/medical exception criteria, ICD-10/CPT coding, documentation, and distribution/hub/reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need and payer/KPSP demand; develop territory engagement plans.
- Adhere to non-promotional guidelines, legal/compliance/privacy guardrails, and patient confidentiality.
Knowledge, Skills, Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices; navigate payer portals/CRM/access tools.
- Strong communication/training/relationship-building, analytical and data/reporting skills.
- Experience developing/executing strategic business/account plans; sound judgment.
- Travel 50–70%; proficiency: Outlook, Word, Excel, PowerPoint, Salesforce CRM.
- Valid driver’s license; ability to meet credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep PA/appeals/coverage knowledge; payer knowledge including Medicare, Medicaid, and commercial.
Pay Range:
$136,000–$204,000; eligible for annual bonus and annual equity awards.