Field Reimbursement Manager - Kidney (Great Plains - NV, UT, CO, NE, KS)
Vertex Pharmaceuticals
June 27, 2026
On-site
Colorado, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices by providing non-promotional access and reimbursement education. Troubleshoot access and apply territory payer expertise to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Establish compliant relationships with nephrology office staff involved in prior authorizations and patient access.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay/PAP/Bridge and other affordability pathways; ensure offices follow insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training covering payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding and documentation, and distribution/hub/reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need and payer dynamics.
- Adhere to non-promotional guidelines, comply with legal/compliance/privacy requirements, and maintain patient confidentiality.
Knowledge/Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP/office staff.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training, analytical, and data/reporting skills.
- Travel 50–70%; valid driver’s license; Microsoft Outlook/Word/Excel/PowerPoint/Salesforce CRM.
Education/Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree a plus.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep benefits investigation/PA/appeals/coverage-policy expertise; knowledge of Medicare/Medicaid/commercial plans.
Compensation:
- $136,000–$204,000 base salary; eligible for annual bonus and annual equity awards.
Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices by providing non-promotional access and reimbursement education. Troubleshoot access and apply territory payer expertise to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Establish compliant relationships with nephrology office staff involved in prior authorizations and patient access.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay/PAP/Bridge and other affordability pathways; ensure offices follow insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training covering payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding and documentation, and distribution/hub/reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need and payer dynamics.
- Adhere to non-promotional guidelines, comply with legal/compliance/privacy requirements, and maintain patient confidentiality.
Knowledge/Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP/office staff.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training, analytical, and data/reporting skills.
- Travel 50–70%; valid driver’s license; Microsoft Outlook/Word/Excel/PowerPoint/Salesforce CRM.
Education/Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree a plus.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep benefits investigation/PA/appeals/coverage-policy expertise; knowledge of Medicare/Medicaid/commercial plans.
Compensation:
- $136,000–$204,000 base salary; eligible for annual bonus and annual equity awards.