Field Reimbursement Manager - Kidney (IN-KY-TN)
Vertex Pharmaceuticals
June 27, 2026
On-site
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, troubleshooting to support timely patient access, and applying territory-level payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office care team/admin staff (prior auth and patient access).
- Partner with case management on escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways; provide timely case follow-up and clarify insurance documentation.
- Maintain understanding of commercial/government coverage, PA/appeals, and payer trends.
- Conduct on-site/virtual in-services and trainings covering payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; develop engagement plans; adhere to strict non-promotional, legal/compliance/privacy requirements; maintain patient confidentiality.
Knowledge And Skills (Qualifications):
- Specialty biologics/rare disease/complex pharmacy benefit experience.
- Account management with HCPs/office staff; payer portal/CRM/tool navigation.
- Strong training/relationship and analytical skills; data/reporting to prioritize caseload.
- Travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint), Salesforce CRM; valid driver’s license; credentialing for facility entry.
Education/Experience:
- Bachelor’s in healthcare/life sciences/business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep understanding of benefits investigations, PA/appeals, and Medicare/Medicaid/commercial coverage.
Pay Range:
$136,000–$204,000.
Benefits (as stated):
Annual bonus and equity; medical/dental/vision; paid time off (incl. week-long summer/winter shutdown); educational assistance/student loan repayment; commuting subsidy; matching charitable donations; 401(k); potential overtime per requirements.
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, troubleshooting to support timely patient access, and applying territory-level payer expertise.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office care team/admin staff (prior auth and patient access).
- Partner with case management on escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways; provide timely case follow-up and clarify insurance documentation.
- Maintain understanding of commercial/government coverage, PA/appeals, and payer trends.
- Conduct on-site/virtual in-services and trainings covering payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; develop engagement plans; adhere to strict non-promotional, legal/compliance/privacy requirements; maintain patient confidentiality.
Knowledge And Skills (Qualifications):
- Specialty biologics/rare disease/complex pharmacy benefit experience.
- Account management with HCPs/office staff; payer portal/CRM/tool navigation.
- Strong training/relationship and analytical skills; data/reporting to prioritize caseload.
- Travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint), Salesforce CRM; valid driver’s license; credentialing for facility entry.
Education/Experience:
- Bachelor’s in healthcare/life sciences/business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep understanding of benefits investigations, PA/appeals, and Medicare/Medicaid/commercial coverage.
Pay Range:
$136,000–$204,000.
Benefits (as stated):
Annual bonus and equity; medical/dental/vision; paid time off (incl. week-long summer/winter shutdown); educational assistance/student loan repayment; commuting subsidy; matching charitable donations; 401(k); potential overtime per requirements.