Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)
Vertex Pharmaceuticals
June 27, 2026
On-site
Greater Anchorage Area
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; troubleshooting to support timely patient access.
Key Duties and Responsibilities
- Build compliant relationships with nephrology office care/administrative staff for prior authorization and patient access.
- Partner with case management to address escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial/government coverage requirements and payer trends.
- Conduct in-services and training (on-site/virtual) on payer policies/formulary updates, PA/exception criteria, ICD-10/CPT coding and documentation, and hub/distribution/reimbursement workflows.
- Independently manage a multi-state territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; adhere to strict non-promotional guidelines and maintain patient confidentiality.
Knowledge, Skills, and Requirements
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCPs/office staff to navigate access challenges.
- Ability to navigate payer portals and CRM/tools; strong communication/training/relationship skills.
- Analytical and data/reporting skills; strategic business/account planning.
- Travel 50–70% within territory; valid driver’s license; Microsoft Office and Salesforce CRM.
Education and Experience
- Bachelor’s degree (healthcare/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy/patient services, or field access.
- Deep understanding of benefits investigations, PA, appeals, coverage policies, and Medicare/Medicaid/commercial.
Compensation/Benefits (as stated)
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- 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; troubleshooting to support timely patient access.
Key Duties and Responsibilities
- Build compliant relationships with nephrology office care/administrative staff for prior authorization and patient access.
- Partner with case management to address escalated access issues; coordinate handoffs using CRM workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial/government coverage requirements and payer trends.
- Conduct in-services and training (on-site/virtual) on payer policies/formulary updates, PA/exception criteria, ICD-10/CPT coding and documentation, and hub/distribution/reimbursement workflows.
- Independently manage a multi-state territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; adhere to strict non-promotional guidelines and maintain patient confidentiality.
Knowledge, Skills, and Requirements
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management with HCPs/office staff to navigate access challenges.
- Ability to navigate payer portals and CRM/tools; strong communication/training/relationship skills.
- Analytical and data/reporting skills; strategic business/account planning.
- Travel 50–70% within territory; valid driver’s license; Microsoft Office and Salesforce CRM.
Education and Experience
- Bachelor’s degree (healthcare/life sciences/business); 5+ years in sales, reimbursement, market access, specialty pharmacy/patient services, or field access.
- Deep understanding of benefits investigations, PA, appeals, coverage policies, and Medicare/Medicaid/commercial.
Compensation/Benefits (as stated)
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.