Field Reimbursement Manager - Kidney (South Central - AR, MS, LA, TN)
Vertex Pharmaceuticals
June 27, 2026
On-site
United States
Market Access
General Summary:
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education and support timely patient access via troubleshooting and payer expertise.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and patient access.
- Partner with case management to address escalated access issues and coordinate handoffs using CRM 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, PA trends, and access.
- Conduct on-site and virtual in-services/training on payer policies, formulary updates, PA/exception criteria, ICD-10/CPT coding, documentation, distribution pathways, hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Adhere to strict non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge and Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field tools; strong communication and training skills.
- Analytical and data/reporting skills to manage caseload and prioritize needs.
- Travel 50–70% within territory; Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare rep credentialing requirements.
Education and Experience:
- Bachelor’s degree in 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; payer knowledge (Medicare, Medicaid, commercial).
Pay/Benefits:
- Annual bonus and annual equity awards (and other listed total rewards benefits).
Application Instructions:
- For accommodation during hiring: ApplicationAssistance@vrtx.com
- Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as a local subject matter expert to nephrology practices. Provide non-promotional access and reimbursement education and support timely patient access via troubleshooting and payer expertise.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel involved in prior authorizations and patient access.
- Partner with case management to address escalated access issues and coordinate handoffs using CRM 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, PA trends, and access.
- Conduct on-site and virtual in-services/training on payer policies, formulary updates, PA/exception criteria, ICD-10/CPT coding, documentation, distribution pathways, hub services, enrollment, and reimbursement workflows.
- Manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Adhere to strict non-promotional and compliance/privacy guardrails; maintain patient confidentiality.
Knowledge and Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Ability to navigate payer portals, CRM systems, and field tools; strong communication and training skills.
- Analytical and data/reporting skills to manage caseload and prioritize needs.
- Travel 50–70% within territory; Microsoft Office and Salesforce CRM.
- Valid driver’s license; meet healthcare rep credentialing requirements.
Education and Experience:
- Bachelor’s degree in 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; payer knowledge (Medicare, Medicaid, commercial).
Pay/Benefits:
- Annual bonus and annual equity awards (and other listed total rewards benefits).
Application Instructions:
- For accommodation during hiring: ApplicationAssistance@vrtx.com