Field Reimbursement Manager - Kidney (Michigan-North Ohio)
Vertex Pharmaceuticals
August 18, 2026
Remote friendly (United States)
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 to provide non-promotional reimbursement/access education and troubleshoot to support timely patient access to prescribed kidney therapies.
Key Duties & Responsibilities
- Build compliant relationships with nephrology office care teams and administrative staff (prior authorizations/patient access).
- 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; provide timely case follow-up.
- Maintain knowledge of commercial and government prescription coverage/access and payer trends.
- Deliver on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; develop territory engagement plans to reduce access barriers.
- Follow strict non-promotional guidelines, protect patient confidentiality, and adhere to all applicable laws/regulations.
Knowledge & Skills
- Specialty biologics/rare disease access or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals/CRM and field access tools; strong training/relationship skills.
- Analytical/reporting skills to manage caseload and prioritize patient needs.
- Travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint) and Salesforce CRM; valid driver’s license.
Education & Experience
- Bachelor’s degree (health care/life sciences/business); advanced degree preferred.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep knowledge of benefits investigations, PA processes/appeals, and payer ecosystems; Medicare/Medicaid/commercial expertise.
Compensation
- Pay range: $136,000–$204,000. Eligible for annual bonus and annual equity awards.
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices to provide non-promotional reimbursement/access education and troubleshoot to support timely patient access to prescribed kidney therapies.
Key Duties & Responsibilities
- Build compliant relationships with nephrology office care teams and administrative staff (prior authorizations/patient access).
- 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; provide timely case follow-up.
- Maintain knowledge of commercial and government prescription coverage/access and payer trends.
- Deliver on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; develop territory engagement plans to reduce access barriers.
- Follow strict non-promotional guidelines, protect patient confidentiality, and adhere to all applicable laws/regulations.
Knowledge & Skills
- Specialty biologics/rare disease access or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals/CRM and field access tools; strong training/relationship skills.
- Analytical/reporting skills to manage caseload and prioritize patient needs.
- Travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint) and Salesforce CRM; valid driver’s license.
Education & Experience
- Bachelor’s degree (health care/life sciences/business); advanced degree preferred.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep knowledge of benefits investigations, PA processes/appeals, and payer ecosystems; Medicare/Medicaid/commercial expertise.
Compensation
- Pay range: $136,000–$204,000. Eligible for annual bonus and annual equity awards.