Field Reimbursement Manager - Kidney (Great Plains - NV, UT, CO, NE, KS)
Vertex Pharmaceuticals
June 27, 2026
On-site
Nebraska, 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 and supporting timely patient access through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office staff (care team and prior authorization/patient access administrators).
- 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 and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exceptions, coding (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multi-state territory, prioritizing accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; minimize patient-specific access barriers.
- Follow strict non-promotional, legal/compliance/privacy requirements; maintain confidentiality.
Knowledge, Skills, And Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices; navigate payer portals/CRM/tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic account planning; sound judgment; travel 50–70%.
- Proficient in Microsoft Outlook/Word/Excel/PowerPoint and Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- Bachelor’s degree 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; Medicare/Medicaid/commercial payer knowledge.
Application Instructions:
Request accommodations via recruiter/hiring manager; contact Talent Acquisition at ApplicationAssistance@vrtx.com.
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 and supporting timely patient access through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office staff (care team and prior authorization/patient access administrators).
- 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 and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exceptions, coding (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multi-state territory, prioritizing accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; minimize patient-specific access barriers.
- Follow strict non-promotional, legal/compliance/privacy requirements; maintain confidentiality.
Knowledge, Skills, And Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices; navigate payer portals/CRM/tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic account planning; sound judgment; travel 50–70%.
- Proficient in Microsoft Outlook/Word/Excel/PowerPoint and Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- Bachelor’s degree 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; Medicare/Medicaid/commercial payer knowledge.
Application Instructions:
Request accommodations via recruiter/hiring manager; contact Talent Acquisition at ApplicationAssistance@vrtx.com.