Field Reimbursement Manager - Kidney (Southeast - AL, GA, FL)
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 access to prescribed Vertex kidney therapies through troubleshooting and territory-level payer expertise.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office personnel to support patient access to specialty medications.
- Partner with case management to address escalated access issues; ensure coordinated 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 understanding of commercial and government prescription insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Adhere to non-promotional guidelines and maintain patient confidentiality while following laws and company policies.
Knowledge, Skills, And Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management experience with HCP offices; navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building; analytical skills; data/reporting tool use.
- Ability to develop/execute strategic account plans; judgment in problem-solving.
- Travel 50–70% within territory; valid driver’s license; Microsoft Outlook/Word/Excel/PowerPoint/Salesforce CRM.
Education And Experience:
- Bachelor’s degree in health care, life sciences, or business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and payer ecosystems.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.
Pay Range: $136,000 - $204,000
Benefits (if applicable, as listed): annual bonus; annual equity awards; eligible for overtime (per requirements); medical/dental/vision; paid time off (summer/winter shutdown); educational assistance/student loan repayment; commuting subsidy; matching charitable donations; 401(k) and more.
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 access to prescribed Vertex kidney therapies through troubleshooting and territory-level payer expertise.
Key Duties And Responsibilities:
- Establish compliant connections with nephrology office personnel to support patient access to specialty medications.
- Partner with case management to address escalated access issues; ensure coordinated 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 understanding of commercial and government prescription insurance coverage requirements and payer trends.
- Conduct compliant on-site/virtual in-services and training on payer policies, PA/medical exception criteria, coding/billing (ICD-10, CPT), documentation, distribution/hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate region; prioritize accounts based on patient need, payer dynamics, and KPSP demand.
- Adhere to non-promotional guidelines and maintain patient confidentiality while following laws and company policies.
Knowledge, Skills, And Qualifications:
- Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products.
- Account management experience with HCP offices; navigate payer portals, CRM systems, and field access tools.
- Strong communication/training/relationship-building; analytical skills; data/reporting tool use.
- Ability to develop/execute strategic account plans; judgment in problem-solving.
- Travel 50–70% within territory; valid driver’s license; Microsoft Outlook/Word/Excel/PowerPoint/Salesforce CRM.
Education And Experience:
- Bachelor’s degree in health care, life sciences, or business (advanced degree a plus).
- 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field-based access roles.
- Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and payer ecosystems.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.
Pay Range: $136,000 - $204,000
Benefits (if applicable, as listed): annual bonus; annual equity awards; eligible for overtime (per requirements); medical/dental/vision; paid time off (summer/winter shutdown); educational assistance/student loan repayment; commuting subsidy; matching charitable donations; 401(k) and more.