Field Reimbursement Manager - Kidney (North Central - IA, MO, IL)
Vertex Pharmaceuticals
June 25, 2026
On-site
Springfield-Branson, Missouri Area
Market Access
Field Reimbursement Manager (Kidney Patient Support Program - KPSP)
Key Duties And Responsibilities
- Build compliant relationships with nephrology office care team/admin staff to support prior authorizations and patient access to specialty medications.
- Coordinate with case management to resolve escalated access issues using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely case follow-up and guidance on insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance requirements and payer trends.
- Deliver compliant on-site/virtual in-services and trainings covering regional payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT coding and documentation, and distribution/hub and reimbursement workflows.
- Independently manage a multistate territory; create territory engagement plans to reduce patient-specific access barriers.
- Adhere to non-promotional guidelines; maintain confidentiality of patient health information and comply with applicable laws/regulations and company policies.
Knowledge And Skills / Qualifications
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices to navigate complex access challenges; ability to use payer portals and CRM tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Ability to develop/executing strategic account plans; sound judgment; travel 50–70%.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
- Valid driver’s license and credentialing to enter facilities.
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 roles.
- Deep understanding of benefits investigations, PA/appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Pay Range / Benefits
- $136,000–$204,000 base salary. Eligible for annual bonus and annual equity awards.
Application Instructions
- Contact recruiter/hiring manager for process accommodation; ApplicationAssistance@vrtx.com.
Key Duties And Responsibilities
- Build compliant relationships with nephrology office care team/admin staff to support prior authorizations and patient access to specialty medications.
- Coordinate with case management to resolve escalated access issues using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely case follow-up and guidance on insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance requirements and payer trends.
- Deliver compliant on-site/virtual in-services and trainings covering regional payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT coding and documentation, and distribution/hub and reimbursement workflows.
- Independently manage a multistate territory; create territory engagement plans to reduce patient-specific access barriers.
- Adhere to non-promotional guidelines; maintain confidentiality of patient health information and comply with applicable laws/regulations and company policies.
Knowledge And Skills / Qualifications
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCP offices to navigate complex access challenges; ability to use payer portals and CRM tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Ability to develop/executing strategic account plans; sound judgment; travel 50–70%.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM.
- Valid driver’s license and credentialing to enter facilities.
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 roles.
- Deep understanding of benefits investigations, PA/appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Pay Range / Benefits
- $136,000–$204,000 base salary. Eligible for annual bonus and annual equity awards.
Application Instructions
- Contact recruiter/hiring manager for process accommodation; ApplicationAssistance@vrtx.com.