Field Reimbursement Manager - Kidney (Michigan-North Ohio)
Vertex Pharmaceuticals
August 09, 2026
Remote friendly (Michigan, United States)
United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education; troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Establish compliant connections with nephrology office personnel to support patient access to prescribed specialty medications.
- Partner with case management to address escalated access issues; ensure coordinated handoffs using CRM triggers and workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely follow-up on case status and documentation requirements.
- Maintain understanding of commercial and government coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD-10/CPT coding and documentation, distribution pathways/hub services/enrollment, and reimbursement workflows.
- Independently manage a multistate territory; develop territory engagement plans to minimize patient-specific access barriers.
- Follow strict non-promotional guidelines; maintain confidentiality and comply with laws, regulations, and company policies.
Knowledge, Skills, and Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products; account management with HCP offices.
- Ability to navigate payer portals and CRM/field access tools; strong communication/training/relationship-building skills.
- Analytical skills; data/reporting ability to manage caseload and prioritize needs.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep benefits investigation and PA/appeals/coverage policy knowledge; payer knowledge of Medicare, Medicaid, and commercial.
- Bachelor’s degree (health care, life sciences, or business); advanced degree a plus.
- Travel 50–70%; proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license and ability to meet credentialing requirements.
Application Instructions:
- Contact recruiter or hiring manager; for application assistance: ApplicationAssistance@vrtx.com.
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP). Serve as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education; troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Establish compliant connections with nephrology office personnel to support patient access to prescribed specialty medications.
- Partner with case management to address escalated access issues; ensure coordinated handoffs using CRM triggers and workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely follow-up on case status and documentation requirements.
- Maintain understanding of commercial and government coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD-10/CPT coding and documentation, distribution pathways/hub services/enrollment, and reimbursement workflows.
- Independently manage a multistate territory; develop territory engagement plans to minimize patient-specific access barriers.
- Follow strict non-promotional guidelines; maintain confidentiality and comply with laws, regulations, and company policies.
Knowledge, Skills, and Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products; account management with HCP offices.
- Ability to navigate payer portals and CRM/field access tools; strong communication/training/relationship-building skills.
- Analytical skills; data/reporting ability to manage caseload and prioritize needs.
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep benefits investigation and PA/appeals/coverage policy knowledge; payer knowledge of Medicare, Medicaid, and commercial.
- Bachelor’s degree (health care, life sciences, or business); advanced degree a plus.
- Travel 50–70%; proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license and ability to meet credentialing requirements.
Application Instructions:
- Contact recruiter or hiring manager; for application assistance: ApplicationAssistance@vrtx.com.