Field Reimbursement Manager - Kidney (North Carolina-Virginia)
Vertex Pharmaceuticals
June 27, 2026
On-site
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, and support timely patient access through troubleshooting and territory payer expertise.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel involved in prior authorizations and specialty medication 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.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary, PA/medical exception criteria, ICD-10/CPT coding, documentation, hub services/enrollment, and reimbursement workflows.
- Manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and legal/compliance/privacy guardrails.
- Maintain confidentiality and comply with laws/regulations and company policies; apply program business rules.
Knowledge And Skills / Qualifications:
- Experience with specialty biologics/rare disease/comples pharmacy benefit products.
- Account management with HCPs/office staff; ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship skills; analytical and data/reporting skills.
- Strategic business/account planning experience; good judgment/problem solving.
- Travel 50–70% in assigned territory; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep benefits investigation/PA/appeals/coverage/payer ecosystem knowledge; Medicare/Medicaid/commercial payer knowledge.
Pay Range:
- $136,000 - $204,000
Benefits (if listed in posting):
- Annual bonus and annual equity awards; medical/dental/vision benefits; paid time off (including week-long summer and winter shutdown); educational assistance (incl. student loan repayment); commuting subsidy; matching charitable donations; 401(k).
Application Instructions:
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for accommodation requests related to hiring process or essential functions.
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, and support timely patient access through troubleshooting and territory payer expertise.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel involved in prior authorizations and specialty medication 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.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary, PA/medical exception criteria, ICD-10/CPT coding, documentation, hub services/enrollment, and reimbursement workflows.
- Manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and legal/compliance/privacy guardrails.
- Maintain confidentiality and comply with laws/regulations and company policies; apply program business rules.
Knowledge And Skills / Qualifications:
- Experience with specialty biologics/rare disease/comples pharmacy benefit products.
- Account management with HCPs/office staff; ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship skills; analytical and data/reporting skills.
- Strategic business/account planning experience; good judgment/problem solving.
- Travel 50–70% in assigned territory; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep benefits investigation/PA/appeals/coverage/payer ecosystem knowledge; Medicare/Medicaid/commercial payer knowledge.
Pay Range:
- $136,000 - $204,000
Benefits (if listed in posting):
- Annual bonus and annual equity awards; medical/dental/vision benefits; paid time off (including week-long summer and winter shutdown); educational assistance (incl. student loan repayment); commuting subsidy; matching charitable donations; 401(k).
Application Instructions:
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for accommodation requests related to hiring process or essential functions.