Field Reimbursement Manager - Kidney (New England - ME, VT, NH, MA, RI, CT)
Vertex Pharmaceuticals
June 27, 2026
On-site
New Hampshire, United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education and troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to resolve escalated access issues and coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain understanding of commercial and government prescription coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates, PA/exception criteria, ICD-10/CPT coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand; adapt to office workflows.
- Develop territory engagement plans to reduce patient-specific access barriers.
- Adhere to strict non-promotional guidelines and relevant compliance/privacy requirements; maintain patient health information confidentiality.
Knowledge And Skills / Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building, analytical, and data/reporting skills.
- Travel 50–70% within territory; valid driver’s license.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA, appeals, coverage policies, and payer ecosystems (Medicare/Medicaid/commercial).
Application Instructions:
- Not provided in the job description text.
- Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education and troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to resolve escalated access issues and coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain understanding of commercial and government prescription coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates, PA/exception criteria, ICD-10/CPT coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand; adapt to office workflows.
- Develop territory engagement plans to reduce patient-specific access barriers.
- Adhere to strict non-promotional guidelines and relevant compliance/privacy requirements; maintain patient health information confidentiality.
Knowledge And Skills / Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building, analytical, and data/reporting skills.
- Travel 50–70% within territory; valid driver’s license.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA, appeals, coverage policies, and payer ecosystems (Medicare/Medicaid/commercial).
Application Instructions:
- Not provided in the job description text.