Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)
Vertex Pharmaceuticals
June 27, 2026
On-site
Washington, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local expert to nephrology practices with non-promotional access and reimbursement education, troubleshooting, and territory-level payer expertise to support timely patient access.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office personnel (care team + prior authorization/patient access staff).
- Partner with case management to address escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Provide follow-up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exceptions, ICD-10/CPT/coding requirements, distribution/hub enrollment and reimbursement workflows.
- Independently manage a multi-state territory; prioritize accounts based on patient need and payer dynamics.
- Develop territory engagement plans; adapt to office workflows; adhere to non-promotional compliance and patient confidentiality.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals and CRM/field tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Ability to travel 50–70%; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- BS in health care/life sciences/business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep understanding of benefits investigations, PA, appeals, and payer ecosystems; Medicare/Medicaid/commercial knowledge.
Pay/Benefits:
- Pay range: $136,000–$204,000; annual bonus and annual equity awards; eligibility for overtime (per law).
- Medical/dental/vision; paid time off; educational assistance (incl. student loan repayment); commuting subsidy; matching charitable donations; 401(k).
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local expert to nephrology practices with non-promotional access and reimbursement education, troubleshooting, and territory-level payer expertise to support timely patient access.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office personnel (care team + prior authorization/patient access staff).
- Partner with case management to address escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Provide follow-up on case status and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exceptions, ICD-10/CPT/coding requirements, distribution/hub enrollment and reimbursement workflows.
- Independently manage a multi-state territory; prioritize accounts based on patient need and payer dynamics.
- Develop territory engagement plans; adapt to office workflows; adhere to non-promotional compliance and patient confidentiality.
Knowledge And Skills:
- Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals and CRM/field tools.
- Strong communication/training/relationship-building; analytical and data/reporting skills.
- Ability to travel 50–70%; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare credentialing requirements.
Education And Experience:
- BS in health care/life sciences/business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access.
- Deep understanding of benefits investigations, PA, appeals, and payer ecosystems; Medicare/Medicaid/commercial knowledge.
Pay/Benefits:
- Pay range: $136,000–$204,000; annual bonus and annual equity awards; eligibility for overtime (per law).
- Medical/dental/vision; paid time off; educational assistance (incl. student loan repayment); commuting subsidy; matching charitable donations; 401(k).