Field Reimbursement Manager - Kidney (East Texas-Louisiana)
Vertex Pharmaceuticals
June 27, 2026
On-site
Texas, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager (Kidney Patient Support Program, KPSP) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office care team and administrative staff for prior authorizations and patient access.
- Partner with case management to address escalated access issues; coordinate handoffs via 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 and government prescription coverage requirements and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies/formulary updates; PA/medical exception criteria; ICD-10/CPT and documentation; distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; adapt engagement to office workflows; develop territory engagement plans.
- Follow non-promotional guidelines; maintain confidentiality and comply with laws/regulations and company policies.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals and CRM/tools; strong communication/training/relationship-building.
- Analytical skills; use data/reporting to manage caseload and prioritize.
- Travel 50–70%; proficient with Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
Education And Experience:
- Bachelor’s in health care/life sciences/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/appeals, coverage policies, payer ecosystems; Medicare/Medicaid/commercial.
Pay Range:
$136,000 - $204,000
Benefits (as stated):
Eligible for annual bonus and annual equity; some roles may be eligible for overtime. Total Rewards include medical/dental/vision, paid time off (incl. summer/winter shutdown), educational assistance/student loan repayment, commuting subsidy, 401(k), and more.
Field-based Field Reimbursement Manager (Kidney Patient Support Program, KPSP) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office care team and administrative staff for prior authorizations and patient access.
- Partner with case management to address escalated access issues; coordinate handoffs via 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 and government prescription coverage requirements and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies/formulary updates; PA/medical exception criteria; ICD-10/CPT and documentation; distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; adapt engagement to office workflows; develop territory engagement plans.
- Follow non-promotional guidelines; maintain confidentiality and comply with laws/regulations and company policies.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals and CRM/tools; strong communication/training/relationship-building.
- Analytical skills; use data/reporting to manage caseload and prioritize.
- Travel 50–70%; proficient with Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
Education And Experience:
- Bachelor’s in health care/life sciences/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/appeals, coverage policies, payer ecosystems; Medicare/Medicaid/commercial.
Pay Range:
$136,000 - $204,000
Benefits (as stated):
Eligible for annual bonus and annual equity; some roles may be eligible for overtime. Total Rewards include medical/dental/vision, paid time off (incl. summer/winter shutdown), educational assistance/student loan repayment, commuting subsidy, 401(k), and more.