Field Reimbursement Manager - Kidney (East Texas-Louisiana)
Vertex Pharmaceuticals
June 27, 2026
On-site
United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices; provide non-promotional access and reimbursement education and troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and patient access.
- 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; ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances; PA/medical exception criteria; ICD-10/CPT coding and documentation; distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and privacy/compliance guidelines; maintain patient confidentiality.
Knowledge And Skills (Selected):
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals/CRM/field access tools; strong training/relationship-building; analytical and data/reporting skills.
- Travel 50–70% within territory; proficiency: Outlook, Word, Excel, PowerPoint, Salesforce CRM; valid driver’s license; meet credentialing requirements.
Education And Experience:
- Bachelor’s degree in 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.
- Deep knowledge of benefits investigations, PA, appeals, coverage policies, and payer ecosystems; Medicare/Medicaid/commercial.
Application Instructions:
- Contact recruiter/hiring manager or Talent Acquisition at ApplicationAssistance@vrtx.com for application accommodation requests.
- Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices; provide non-promotional access and reimbursement education and troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and patient access.
- 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; ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances; PA/medical exception criteria; ICD-10/CPT coding and documentation; distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and privacy/compliance guidelines; maintain patient confidentiality.
Knowledge And Skills (Selected):
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals/CRM/field access tools; strong training/relationship-building; analytical and data/reporting skills.
- Travel 50–70% within territory; proficiency: Outlook, Word, Excel, PowerPoint, Salesforce CRM; valid driver’s license; meet credentialing requirements.
Education And Experience:
- Bachelor’s degree in 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.
- Deep knowledge of benefits investigations, PA, appeals, coverage policies, and payer ecosystems; Medicare/Medicaid/commercial.
Application Instructions:
- Contact recruiter/hiring manager or Talent Acquisition at ApplicationAssistance@vrtx.com for application accommodation requests.