Field Reimbursement Manager - Kidney (OH-PA)
Vertex Pharmaceuticals
June 27, 2026
On-site
Pennsylvania, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office care team/administrative staff involved in prior authorizations and patient access.
- Partner with case management on 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 insurance documentation requirements are understood.
- Maintain knowledge of commercial/government insurance requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances; PA/medical exception criteria; ICD-10/CPT, and documentation requirements; distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge, Skills & Qualifications:
- Specialty biologics/rare disease or complex pharmacy benefit experience.
- Account management with HCP/office staff; ability to navigate payer portals, CRM, and field tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic account planning; sound judgment; travel 50–70%.
- Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM; valid driver’s license and credentialing requirements.
Education & Experience:
- Bachelor’s 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 roles.
- Deep knowledge of benefits investigations, PA processes, appeals, coverage policies, and Medicare/Medicaid/commercial.
Pay/Benefits:
- $136,000–$204,000; annual bonus and annual equity awards.
- Benefits include medical/dental/vision, paid time off, educational assistance/student loan repayment, commuting subsidy, matching charitable donations, and 401(k).
Application/Contact:
- For hiring-process accommodations, contact Talent Acquisition at ApplicationAssistance@vrtx.com.
Field-based Field Reimbursement Manager (Kidney Patient Support Program) serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education and troubleshooting to support timely patient access.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office care team/administrative staff involved in prior authorizations and patient access.
- Partner with case management on 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 insurance documentation requirements are understood.
- Maintain knowledge of commercial/government insurance requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, coverage nuances; PA/medical exception criteria; ICD-10/CPT, and documentation requirements; distribution/hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans to minimize access barriers; adhere to non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge, Skills & Qualifications:
- Specialty biologics/rare disease or complex pharmacy benefit experience.
- Account management with HCP/office staff; ability to navigate payer portals, CRM, and field tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Strategic account planning; sound judgment; travel 50–70%.
- Microsoft Outlook/Word/Excel/PowerPoint; Salesforce CRM; valid driver’s license and credentialing requirements.
Education & Experience:
- Bachelor’s 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 roles.
- Deep knowledge of benefits investigations, PA processes, appeals, coverage policies, and Medicare/Medicaid/commercial.
Pay/Benefits:
- $136,000–$204,000; annual bonus and annual equity awards.
- Benefits include medical/dental/vision, paid time off, educational assistance/student loan repayment, commuting subsidy, matching charitable donations, and 401(k).
Application/Contact:
- For hiring-process accommodations, contact Talent Acquisition at ApplicationAssistance@vrtx.com.