Field Reimbursement Manager - Kidney (Central Southwest - AZ, NM, TX, OK)
Vertex Pharmaceuticals
June 27, 2026
On-site
New Mexico, 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 by providing non-promotional access and reimbursement education, troubleshooting to support timely patient access, and providing territory-level payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel (care team and administrative staff) to support prior authorizations and patient access to specialty medications.
- Partner with case management to address escalated access issues using coordinated CRM triggers/workflows.
- Educate offices on copay/PAP/Bridge programs and other affordability pathways to support timely access.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain understanding of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD-10/CPT coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand; develop territory engagement plans.
- Adhere to non-promotional guidelines, maintain patient HIPAA confidentiality, and comply with applicable laws/regulations and Vertex policies.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management; payer portal/CRM navigation; strong communication/training/relationship-building; analytical and data/reporting skills; strategic account planning; good judgment; travel 50–70%.
- Proficient in Microsoft Office and Salesforce CRM; valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- Bachelor’s degree (health care, life sciences, or business); advanced degree preferred.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, and payer ecosystems; knowledge of Medicare/Medicaid/commercial plans.
Compensation/Benefits:
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off, educational assistance (incl. student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application Instructions:
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for hiring accommodations requests.
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices by providing non-promotional access and reimbursement education, troubleshooting to support timely patient access, and providing territory-level payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel (care team and administrative staff) to support prior authorizations and patient access to specialty medications.
- Partner with case management to address escalated access issues using coordinated CRM triggers/workflows.
- Educate offices on copay/PAP/Bridge programs and other affordability pathways to support timely access.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain understanding of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD-10/CPT coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand; develop territory engagement plans.
- Adhere to non-promotional guidelines, maintain patient HIPAA confidentiality, and comply with applicable laws/regulations and Vertex policies.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management; payer portal/CRM navigation; strong communication/training/relationship-building; analytical and data/reporting skills; strategic account planning; good judgment; travel 50–70%.
- Proficient in Microsoft Office and Salesforce CRM; valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- Bachelor’s degree (health care, life sciences, or business); advanced degree preferred.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, and payer ecosystems; knowledge of Medicare/Medicaid/commercial plans.
Compensation/Benefits:
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off, educational assistance (incl. student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application Instructions:
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for hiring accommodations requests.