Field Reimbursement Manager - Kidney (Great Plains - NV, UT, CO, NE, KS)
Vertex Pharmaceuticals
June 27, 2026
On-site
Nevada, United States
Market Access
Field Reimbursement Manager (Kidney Patient Support Program - KPSP)
General Summary
- Field-based subject matter expert for nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties and Responsibilities
- Build compliant relationships with nephrology office care teams and prior authorization/patient access staff.
- Coordinate with case management to resolve escalated access issues using CRM 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 insurance coverage and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exceptions, ICD-10/CPT, distribution/hub enrollment and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to reduce patient-specific access barriers.
Knowledge/Skills/Qualifications
- Specialty biologics/rare disease or complex pharmacy benefit experience.
- Account management experience with HCP offices to navigate access challenges.
- Ability to use payer portals and CRM/field tools; strong training/relationship skills.
- Analytical skills; data/reporting use to manage caseload and prioritize.
- 50–70% travel; valid driver’s license; health care rep credentialing.
- MS Office and Salesforce CRM proficiency.
Education/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 roles.
- Deep understanding of benefits investigations, PA, appeals, coverage, and payer ecosystems; knowledge of Medicare/Medicaid/commercial.
Compensation/Benefits (as stated)
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long summer and winter shutdown), educational assistance/student loan repayment, commuting subsidy, charitable donations, and 401(k).
General Summary
- Field-based subject matter expert for nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties and Responsibilities
- Build compliant relationships with nephrology office care teams and prior authorization/patient access staff.
- Coordinate with case management to resolve escalated access issues using CRM 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 insurance coverage and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exceptions, ICD-10/CPT, distribution/hub enrollment and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to reduce patient-specific access barriers.
Knowledge/Skills/Qualifications
- Specialty biologics/rare disease or complex pharmacy benefit experience.
- Account management experience with HCP offices to navigate access challenges.
- Ability to use payer portals and CRM/field tools; strong training/relationship skills.
- Analytical skills; data/reporting use to manage caseload and prioritize.
- 50–70% travel; valid driver’s license; health care rep credentialing.
- MS Office and Salesforce CRM proficiency.
Education/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 roles.
- Deep understanding of benefits investigations, PA, appeals, coverage, and payer ecosystems; knowledge of Medicare/Medicaid/commercial.
Compensation/Benefits (as stated)
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long summer and winter shutdown), educational assistance/student loan repayment, commuting subsidy, charitable donations, and 401(k).