Field Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN)
Vertex Pharmaceuticals
3 days ago
On-site
Louisiana, United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices and providing non-promotional access and reimbursement education; troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office care teams and administrative staff supporting prior authorizations and specialty medication access.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain knowledge of commercial and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, ICD-10/CPT coding, documentation, distribution pathways/hub services/enrollment and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; follow strict non-promotional guidelines; maintain patient confidentiality; apply program business rules.
Knowledge And Skills (select requirements):
- Experience with specialty biologics/rare disease therapies or complex pharmacy benefit products; account management with HCP offices.
- Strong payer expertise and ability to navigate payer portals and CRM/field tools.
- Excellent communication, training, relationship-building, analytical, and data/reporting skills.
- Ability to travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint) and Salesforce CRM; valid driver’s license; meet credentialing requirements.
Education And Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree preferred.
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access roles.
- Deep understanding of benefits investigations, PA/appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Compensation/Benefits:
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long company shutdown in Summer and Winter), educational assistance (incl. student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application Instructions:
- Contact ApplicationAssistance@vrtx.com for hiring-process accommodation requests.
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices and providing non-promotional access and reimbursement education; troubleshoot to support timely patient access to prescribed Vertex kidney therapies.
Key Duties And Responsibilities:
- Build compliant relationships with nephrology office care teams and administrative staff supporting prior authorizations and specialty medication access.
- Partner with case management to resolve escalated access issues; coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Maintain knowledge of commercial and government prescription coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, ICD-10/CPT coding, documentation, distribution pathways/hub services/enrollment and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; follow strict non-promotional guidelines; maintain patient confidentiality; apply program business rules.
Knowledge And Skills (select requirements):
- Experience with specialty biologics/rare disease therapies or complex pharmacy benefit products; account management with HCP offices.
- Strong payer expertise and ability to navigate payer portals and CRM/field tools.
- Excellent communication, training, relationship-building, analytical, and data/reporting skills.
- Ability to travel 50–70%; Microsoft Office (Outlook/Word/Excel/PowerPoint) and Salesforce CRM; valid driver’s license; meet credentialing requirements.
Education And Experience:
- Bachelor’s degree (health care/life sciences/business); advanced degree preferred.
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access roles.
- Deep understanding of benefits investigations, PA/appeals, coverage policies, and Medicare/Medicaid/commercial plans.
Compensation/Benefits:
- Pay range: $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long company shutdown in Summer and Winter), educational assistance (incl. student loan repayment), commuting subsidy, matching charitable donations, and 401(k).
Application Instructions:
- Contact ApplicationAssistance@vrtx.com for hiring-process accommodation requests.