Field Reimbursement Manager - Kidney (Central California - Los Angeles & San Bernardino)
Vertex Pharmaceuticals
August 18, 2026
Remote friendly (United States)
United States
Market Access
General Summary:
Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, and help ensure timely patient access through troubleshooting and payer expertise.
Key Duties and Responsibilities:
- Compliantly connect with nephrology care team/administrative staff to support patient access and prior authorization for specialty medications.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial/government coverage requirements and payer trends.
- Conduct compliant on-site and virtual in-services/training on payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution pathways/hub services/enrollment/reimbursement workflows.
- Manage a multistate territory; prioritize accounts by patient need and payer dynamics.
- Develop territory engagement plans; adhere to strict non-promotional guidelines; protect patient confidentiality.
Knowledge/Skills:
Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCPs; payer portal/CRM tools; strong training/relationship skills; analytical and data/reporting skills; strategic account planning; judgment/problem-solving; travel 50–70%; Microsoft Office and Salesforce; valid driver’s license; credentialing for facility entry.
Education/Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree a plus.
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access.
- Deep benefits investigations, PA processes/appeals, coverage policies; Medicare/Medicaid/commercial payer knowledge.
Pay Range:
$136,000 - $204,000.
Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, and help ensure timely patient access through troubleshooting and payer expertise.
Key Duties and Responsibilities:
- Compliantly connect with nephrology care team/administrative staff to support patient access and prior authorization for specialty medications.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial/government coverage requirements and payer trends.
- Conduct compliant on-site and virtual in-services/training on payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution pathways/hub services/enrollment/reimbursement workflows.
- Manage a multistate territory; prioritize accounts by patient need and payer dynamics.
- Develop territory engagement plans; adhere to strict non-promotional guidelines; protect patient confidentiality.
Knowledge/Skills:
Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCPs; payer portal/CRM tools; strong training/relationship skills; analytical and data/reporting skills; strategic account planning; judgment/problem-solving; travel 50–70%; Microsoft Office and Salesforce; valid driver’s license; credentialing for facility entry.
Education/Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree a plus.
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access.
- Deep benefits investigations, PA processes/appeals, coverage policies; Medicare/Medicaid/commercial payer knowledge.
Pay Range:
$136,000 - $204,000.