Field Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN)
Vertex Pharmaceuticals
July 02, 2026
On-site
Louisiana, United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education; troubleshoot and use territory payer expertise to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to address escalated access issues and coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements, payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates; PA/medical exception criteria; coding/billing (ICD-10, CPT); documentation; distribution pathways/hub services/enrollment/reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; minimize patient-specific access barriers while avoiding workflow inefficiencies.
- Adhere to non-promotional guidelines; maintain confidentiality and compliance with laws/regulations and company policies.
Knowledge, Skills, and Qualifications:
- 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, CRM systems, and field access tools.
- Strong communication/training/relationship-building, analytical, and data/reporting skills.
- Experience developing/executing strategic account plans; sound judgment; ability to travel 50–70%.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint, Salesforce CRM.
- Valid driver’s license; meet credentialing requirements.
Education and Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree preferred).
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, payer ecosystems; knowledge of Medicare/Medicaid/commercial plans.
Pay Range:
- $136,000 - $204,000
Application Instructions:
- Apply for the position (contact the recruiter/hiring manager or Talent Acquisition at ApplicationAssistance@vrtx.com for application assistance).
- Field-based Field Reimbursement Manager for Vertex Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education; troubleshoot and use territory payer expertise to support timely patient access to prescribed Vertex kidney therapies.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and specialty medication access.
- Partner with case management to address escalated access issues and coordinate handoffs using CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways.
- Follow up on case status and ensure offices understand insurance documentation requirements.
- Maintain knowledge of commercial and government insurance coverage requirements, payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates; PA/medical exception criteria; coding/billing (ICD-10, CPT); documentation; distribution pathways/hub services/enrollment/reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; minimize patient-specific access barriers while avoiding workflow inefficiencies.
- Adhere to non-promotional guidelines; maintain confidentiality and compliance with laws/regulations and company policies.
Knowledge, Skills, and Qualifications:
- 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, CRM systems, and field access tools.
- Strong communication/training/relationship-building, analytical, and data/reporting skills.
- Experience developing/executing strategic account plans; sound judgment; ability to travel 50–70%.
- Proficiency: Microsoft Outlook/Word/Excel/PowerPoint, Salesforce CRM.
- Valid driver’s license; meet credentialing requirements.
Education and Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree preferred).
- 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, payer ecosystems; knowledge of Medicare/Medicaid/commercial plans.
Pay Range:
- $136,000 - $204,000
Application Instructions:
- Apply for the position (contact the recruiter/hiring manager or Talent Acquisition at ApplicationAssistance@vrtx.com for application assistance).