Field Reimbursement Manager - Kidney (Great Plains - NV, UT, CO, NE, KS)
Vertex Pharmaceuticals
July 02, 2026
On-site
Topeka Metropolitan Area
Market Access
General Summary:
Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and supporting timely patient access via 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; manage coordinated handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely case follow-up and ensure insurance documentation requirements are met.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub enrollment and reimbursement workflows.
- Manage a multistate territory independently; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to strict non-promotional and compliance/privacy requirements; maintain patient confidentiality.
Knowledge/Skills/Requirements:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCPs.
- Ability to navigate payer portals/CRM and use data/reporting tools.
- Strong communication/training/relationship-building and analytical skills.
- Travel 50–70%; valid driver’s license and ability to meet credentialing.
- Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
Education/Experience:
- Bachelor’s degree (health care, life sciences, or business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access.
- Deep understanding of PA, appeals, coverage policies, and Medicare/Medicaid/commercial.
Compensation:
- $136,000–$204,000 base; eligible for annual bonus and annual equity.
Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and supporting timely patient access via 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; manage coordinated handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely case follow-up and ensure insurance documentation requirements are met.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub enrollment and reimbursement workflows.
- Manage a multistate territory independently; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to strict non-promotional and compliance/privacy requirements; maintain patient confidentiality.
Knowledge/Skills/Requirements:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCPs.
- Ability to navigate payer portals/CRM and use data/reporting tools.
- Strong communication/training/relationship-building and analytical skills.
- Travel 50–70%; valid driver’s license and ability to meet credentialing.
- Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
Education/Experience:
- Bachelor’s degree (health care, life sciences, or business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access.
- Deep understanding of PA, appeals, coverage policies, and Medicare/Medicaid/commercial.
Compensation:
- $136,000–$204,000 base; eligible for annual bonus and annual equity.