Field Reimbursement Manager - Kidney (Chicago, IL)
Vertex Pharmaceuticals
June 25, 2026
On-site
United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as a local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, and support timely patient access through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel to support patient access to specialty medications.
- Partner with case management to address escalated access issues and manage coordinated handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation requirements, and reimbursement/hub enrollment workflows.
- Manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans and minimize patient access barriers.
- Adhere to non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge And Skills:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCPs and office staff; ability to navigate payer portals and CRM systems.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Comfortable in fast-paced, results-driven environment; strategic business/account planning.
- Ability to travel 50–70% within territory; valid driver’s license; credentialing for facility access.
Education And Experience:
- Bachelor’s degree (health care, life sciences, or business); advanced degree a plus.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Pay Range:
- $136,000 - $204,000
Benefits (as stated):
- Annual bonus and annual equity awards; may be eligible for overtime; medical/dental/vision, paid time off (company shutdown in Summer/Winter), educational assistance/student loan repayment, commuting subsidy, matching charitable donations, 401(k), and more.
Application Instructions:
- Contact recruiter/hiring manager; for application assistance: ApplicationAssistance@vrtx.com.
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as a local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, and support timely patient access through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel to support patient access to specialty medications.
- Partner with case management to address escalated access issues and manage coordinated handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation requirements, and reimbursement/hub enrollment workflows.
- Manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans and minimize patient access barriers.
- Adhere to non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge And Skills:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCPs and office staff; ability to navigate payer portals and CRM systems.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Comfortable in fast-paced, results-driven environment; strategic business/account planning.
- Ability to travel 50–70% within territory; valid driver’s license; credentialing for facility access.
Education And Experience:
- Bachelor’s degree (health care, life sciences, or business); advanced degree a plus.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Pay Range:
- $136,000 - $204,000
Benefits (as stated):
- Annual bonus and annual equity awards; may be eligible for overtime; medical/dental/vision, paid time off (company shutdown in Summer/Winter), educational assistance/student loan repayment, commuting subsidy, matching charitable donations, 401(k), and more.
Application Instructions:
- Contact recruiter/hiring manager; for application assistance: ApplicationAssistance@vrtx.com.