Field Reimbursement Manager - Kidney (Midwest - ND, SD, WI, MN)
Vertex Pharmaceuticals
June 27, 2026
On-site
South Dakota, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP) in a non-promotional role serving as local subject matter expert to nephrology practices, providing access and reimbursement education and troubleshooting to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to address escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Provide timely follow-up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance requirements and payer trends.
- Deliver on-site/virtual in-services and trainings on payer policies, formulary updates, coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding and documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate geographic region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Create territory engagement plans to minimize patient-specific access barriers.
- Follow non-promotional and compliance/privacy guardrails; maintain confidentiality of patient health information and comply with applicable laws.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools; strong training/communication and analytical/data skills.
- Ability to prioritize caseload; comfort in fast-paced, results-driven environment; strategic account planning.
- Travel 50–70% within territory; proficiency in Microsoft Outlook/Word/Excel/PowerPoint and Salesforce CRM; valid driver’s license; meet healthcare rep credentialing requirements.
Education And Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree a plus).
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA processes, appeals, and coverage policies.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP) in a non-promotional role serving as local subject matter expert to nephrology practices, providing access and reimbursement education and troubleshooting to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to address escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Provide timely follow-up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance requirements and payer trends.
- Deliver on-site/virtual in-services and trainings on payer policies, formulary updates, coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding and documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate geographic region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Create territory engagement plans to minimize patient-specific access barriers.
- Follow non-promotional and compliance/privacy guardrails; maintain confidentiality of patient health information and comply with applicable laws.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools; strong training/communication and analytical/data skills.
- Ability to prioritize caseload; comfort in fast-paced, results-driven environment; strategic account planning.
- Travel 50–70% within territory; proficiency in Microsoft Outlook/Word/Excel/PowerPoint and Salesforce CRM; valid driver’s license; meet healthcare rep credentialing requirements.
Education And Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree a plus).
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA processes, appeals, and coverage policies.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.