Field Reimbursement Manager - Kidney (South Florida)
Vertex Pharmaceuticals
June 27, 2026
On-site
Florida, 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 through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel (care team and prior authorization/patient access staff).
- Partner with case management to address escalated access issues; use CRM triggers/workflows for coordinated handoffs.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely follow-up and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance coverage requirements, PA trends, and access/payer requirements.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD‑10/CPT coding, documentation requirements, and distribution/hub/reimbursement enrollment workflows.
- Independently manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; adhere to strict non-promotional and compliant/legal/privacy guardrails; maintain patient confidentiality.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals, CRM systems, and field access tools; strong communication/training/relationship building.
- Analytical skills; use data/reporting tools for caseload prioritization.
- Ability to work in a fast-paced, results-driven environment; strategic account plan execution.
- Travel 50–70%; Microsoft Outlook/Word/Excel/PowerPoint, Salesforce CRM.
- Valid driver’s license; meet healthcare industry credentialing requirements.
Education And Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree a plus).
- Minimum 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, and payer ecosystems.
Pay Range:
$136,000 - $204,000
Benefits/Pay & Additional Information (explicitly stated):
Annual bonus and annual equity awards; possible overtime pay; medical/dental/vision benefits, paid time off (incl. week-long shutdowns), educational assistance/student loan repayment, commuting subsidy, matching charitable donations, 401(k).
Application Instructions:
Not provided beyond contact: 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 through troubleshooting and payer expertise.
Key Duties And Responsibilities:
- Build compliant connections with nephrology office personnel (care team and prior authorization/patient access staff).
- Partner with case management to address escalated access issues; use CRM triggers/workflows for coordinated handoffs.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide timely follow-up and ensure understanding of insurance documentation requirements.
- Maintain knowledge of commercial and government prescription insurance coverage requirements, PA trends, and access/payer requirements.
- Conduct on-site/virtual in-services and training on payer policies, formulary updates, PA/medical exception criteria, ICD‑10/CPT coding, documentation requirements, and distribution/hub/reimbursement enrollment workflows.
- Independently manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Develop territory engagement plans; adhere to strict non-promotional and compliant/legal/privacy guardrails; maintain patient confidentiality.
Knowledge And Skills:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Navigate payer portals, CRM systems, and field access tools; strong communication/training/relationship building.
- Analytical skills; use data/reporting tools for caseload prioritization.
- Ability to work in a fast-paced, results-driven environment; strategic account plan execution.
- Travel 50–70%; Microsoft Outlook/Word/Excel/PowerPoint, Salesforce CRM.
- Valid driver’s license; meet healthcare industry credentialing requirements.
Education And Experience:
- Bachelor’s degree in healthcare/life sciences/business (advanced degree a plus).
- Minimum 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, and payer ecosystems.
Pay Range:
$136,000 - $204,000
Benefits/Pay & Additional Information (explicitly stated):
Annual bonus and annual equity awards; possible overtime pay; medical/dental/vision benefits, paid time off (incl. week-long shutdowns), educational assistance/student loan repayment, commuting subsidy, matching charitable donations, 401(k).
Application Instructions:
Not provided beyond contact: ApplicationAssistance@vrtx.com.