Field Reimbursement Manager - Kidney (Southeast - AL, GA, FL)
Vertex Pharmaceuticals
June 27, 2026
On-site
Georgia, United States
Market Access
Field Reimbursement Manager (Kidney Patient Support Program)
Key Duties And Responsibilities
- Build compliant relationships with nephrology office care and administrative staff to support prior authorization and patient access to specialty medications.
- Partner with case management to resolve escalated access issues; ensure coordinated CRM handoffs.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide documentation requirement follow-up.
- Maintain understanding of commercial and government insurance coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, PA/medical exception criteria, coding/billing (ICD-10, CPT), distribution pathways, hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand; align engagement with office workflows.
- Adhere to non-promotional guidelines, comply with laws/regulations, and maintain patient confidentiality.
Knowledge And Skills
- Specialty biologics/rare disease access experience; account management with HCP offices.
- Navigate payer portals, CRM/salesforce and field access tools; strong training/communication/relationship skills.
- Analytical skills; use data/reporting to manage caseload and prioritize.
- Travel 50–70%; proficiency with Microsoft Office; valid driver’s license; meet healthcare rep credentialing.
Education And Experience
- Bachelor’s degree (health care, life sciences, or business); advanced degree preferred.
- 5+ years in sales, reimbursement/market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, coverage policies; knowledge of Medicare/Medicaid/commercial.
Compensation/Benefits
- Pay range: $136,000–$204,000; annual bonus and annual equity; overtime may apply. Benefits include medical/dental/vision, paid time off (incl. summer/winter shutdown), educational assistance (incl. student loan repayment), commuting subsidy, charitable matching, and 401(k).
Key Duties And Responsibilities
- Build compliant relationships with nephrology office care and administrative staff to support prior authorization and patient access to specialty medications.
- Partner with case management to resolve escalated access issues; ensure coordinated CRM handoffs.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide documentation requirement follow-up.
- Maintain understanding of commercial and government insurance coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies, PA/medical exception criteria, coding/billing (ICD-10, CPT), distribution pathways, hub services, enrollment, and reimbursement workflows.
- Independently manage a multistate territory; prioritize accounts by patient need, payer dynamics, and KPSP demand; align engagement with office workflows.
- Adhere to non-promotional guidelines, comply with laws/regulations, and maintain patient confidentiality.
Knowledge And Skills
- Specialty biologics/rare disease access experience; account management with HCP offices.
- Navigate payer portals, CRM/salesforce and field access tools; strong training/communication/relationship skills.
- Analytical skills; use data/reporting to manage caseload and prioritize.
- Travel 50–70%; proficiency with Microsoft Office; valid driver’s license; meet healthcare rep credentialing.
Education And Experience
- Bachelor’s degree (health care, life sciences, or business); advanced degree preferred.
- 5+ years in sales, reimbursement/market access, specialty pharmacy, patient services, or field-based access.
- Deep understanding of benefits investigations, PA/appeals, coverage policies; knowledge of Medicare/Medicaid/commercial.
Compensation/Benefits
- Pay range: $136,000–$204,000; annual bonus and annual equity; overtime may apply. Benefits include medical/dental/vision, paid time off (incl. summer/winter shutdown), educational assistance (incl. student loan repayment), commuting subsidy, charitable matching, and 401(k).