Field Reimbursement Manager - Kidney (North Central - IA, MO, IL)
Vertex Pharmaceuticals
June 27, 2026
On-site
United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager in the 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 connections with nephrology office personnel (care team and administrative staff) involved in prior authorizations and patient 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, access, and payer trends.
- Conduct on-site and virtual in-services/training on payer policies/formulary updates, PA/medical exceptions (ICD-10, CPT, documentation), and distribution/hub/reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to reduce patient-specific access barriers.
- Follow strict non-promotional guidelines; maintain confidentiality and comply with applicable laws/regulations and company policies.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCPs/office staff.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic business/account planning; sound judgment; travel 50–70%.
- Proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license; satisfy healthcare industry credentialing requirements.
Education And Experience:
- Bachelor’s degree in health care/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, coverage policies, and payer ecosystems.
- Payer knowledge and understanding of Medicare, Medicaid, and commercial insurance.
Pay Range:
- $136,000 - $204,000.
Benefits/Other:
- Eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (including week-long company shutdowns in summer and winter), educational assistance (including student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application instructions:
- Apply via the standard hiring process; for application assistance contact Talent Acquisition at ApplicationAssistance@vrtx.com.
- Field-based Field Reimbursement Manager in the 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 connections with nephrology office personnel (care team and administrative staff) involved in prior authorizations and patient 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, access, and payer trends.
- Conduct on-site and virtual in-services/training on payer policies/formulary updates, PA/medical exceptions (ICD-10, CPT, documentation), and distribution/hub/reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to reduce patient-specific access barriers.
- Follow strict non-promotional guidelines; maintain confidentiality and comply with applicable laws/regulations and company policies.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCPs/office staff.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic business/account planning; sound judgment; travel 50–70%.
- Proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license; satisfy healthcare industry credentialing requirements.
Education And Experience:
- Bachelor’s degree in health care/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, coverage policies, and payer ecosystems.
- Payer knowledge and understanding of Medicare, Medicaid, and commercial insurance.
Pay Range:
- $136,000 - $204,000.
Benefits/Other:
- Eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (including week-long company shutdowns in summer and winter), educational assistance (including student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application instructions:
- Apply via the standard hiring process; for application assistance contact Talent Acquisition at ApplicationAssistance@vrtx.com.