Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)
Vertex Pharmaceuticals
June 27, 2026
On-site
Montana, United States
Market Access
General Summary
- Field-based Field Reimbursement Manager role serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, troubleshooting to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities
- Build compliant relationships with nephrology care team and administrative staff involved in prior authorizations and patient access.
- Partner with case management on escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements, access requirements, and payer trends.
- Conduct compliant on-site/virtual in-services and training on regional payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Create territory engagement plans to minimize patient-specific access barriers.
- Adhere to non-promotional guidelines, program business rules, and confidentiality requirements.
Knowledge, Skills & Requirements
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building and analytical/data skills.
- Strategic business/account plan experience; sound judgment and problem-solving.
- Travel 50–70%; proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
Education And Experience
- Bachelor’s degree (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; knowledge of Medicare/Medicaid/commercial insurance.
Pay/Benefits
- Pay range: $136,000–$204,000. Eligible for annual bonus and annual equity awards. (Additional benefits were described in the posting.)
Application Instructions
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for application accommodations.
- Field-based Field Reimbursement Manager role serving as local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, troubleshooting to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities
- Build compliant relationships with nephrology care team and administrative staff involved in prior authorizations and patient access.
- Partner with case management on escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements, access requirements, and payer trends.
- Conduct compliant on-site/virtual in-services and training on regional payer policies, formulary/coverage nuances, PA/medical exception criteria, ICD-10/CPT/coding, documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand.
- Create territory engagement plans to minimize patient-specific access barriers.
- Adhere to non-promotional guidelines, program business rules, and confidentiality requirements.
Knowledge, Skills & Requirements
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building and analytical/data skills.
- Strategic business/account plan experience; sound judgment and problem-solving.
- Travel 50–70%; proficiency in Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
Education And Experience
- Bachelor’s degree (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; knowledge of Medicare/Medicaid/commercial insurance.
Pay/Benefits
- Pay range: $136,000–$204,000. Eligible for annual bonus and annual equity awards. (Additional benefits were described in the posting.)
Application Instructions
- Contact Talent Acquisition at ApplicationAssistance@vrtx.com for application accommodations.