Field Reimbursement Manager - Kidney (New England - ME, VT, NH, MA, RI, CT)
Vertex Pharmaceuticals
June 25, 2026
On-site
United States
Market Access
Field Reimbursement Manager (Kidney Patient Support Program - KPSP)
General Summary
- Field-based subject matter expert for nephrology practices, providing non-promotional access and reimbursement education to support timely access to prescribed Vertex kidney therapies.
Key Duties & Responsibilities
- Build compliant connections with nephrology office care team/admin staff (prior authorizations, specialty medication access).
- Partner with case management to resolve escalated access issues using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; follow up on case status and documentation requirements.
- Understand commercial/government prescription insurance requirements and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies, PA/medical exception criteria, ICD-10/CPT, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multi-state territory, prioritize accounts based on patient need/payer dynamics/KPSP demand; develop territory engagement plans.
- Adhere to non-promotional and privacy/compliance requirements.
Knowledge/Skills
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Payer portal/CRM navigation; strong training, relationship-building, analytical, and data/reporting skills.
- Travel 50–70%; valid driver’s license; proficiency in Microsoft Office and Salesforce CRM.
Education & Experience
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, coverage policies; Medicare/Medicaid/commercial.
Pay Range
- $136,000–$204,000; eligible for annual bonus and annual equity.
Benefits (as stated)
- Medical/dental/vision, paid time off (incl. company shutdowns), educational assistance/student loan repayment, commuting subsidy, 401(k), and more.
General Summary
- Field-based subject matter expert for nephrology practices, providing non-promotional access and reimbursement education to support timely access to prescribed Vertex kidney therapies.
Key Duties & Responsibilities
- Build compliant connections with nephrology office care team/admin staff (prior authorizations, specialty medication access).
- Partner with case management to resolve escalated access issues using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; follow up on case status and documentation requirements.
- Understand commercial/government prescription insurance requirements and payer trends.
- Deliver compliant on-site/virtual in-services and training on payer policies, PA/medical exception criteria, ICD-10/CPT, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multi-state territory, prioritize accounts based on patient need/payer dynamics/KPSP demand; develop territory engagement plans.
- Adhere to non-promotional and privacy/compliance requirements.
Knowledge/Skills
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Payer portal/CRM navigation; strong training, relationship-building, analytical, and data/reporting skills.
- Travel 50–70%; valid driver’s license; proficiency in Microsoft Office and Salesforce CRM.
Education & Experience
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, coverage policies; Medicare/Medicaid/commercial.
Pay Range
- $136,000–$204,000; eligible for annual bonus and annual equity.
Benefits (as stated)
- Medical/dental/vision, paid time off (incl. company shutdowns), educational assistance/student loan repayment, commuting subsidy, 401(k), and more.