Field Reimbursement Manager - Kidney (Southeast - AL, GA, FL)
Vertex Pharmaceuticals
June 27, 2026
On-site
Alabama, United States
Market Access
General Summary:
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices and supporting non-promotional access and reimbursement education to enable timely patient access to prescribed kidney therapies.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel for prior authorization and patient access.
- Partner with case management to resolve escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Understand commercial and government prescription coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, ICD-10/CPT and documentation, and distribution/hub/reimbursement workflows.
- Manage a multistate region, prioritize accounts, adapt to office workflows, and develop territory engagement plans to reduce access barriers.
- Follow non-promotional, compliance, privacy, and confidentiality requirements; apply program business rules for a consistent patient/customer experience.
Knowledge and Skills/Qualifications:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Payer portal/CRM navigation; strong communication/training/relationship-building.
- Analytical skills, data/reporting use to prioritize caseload; strategic planning experience.
- Travel 50–70%; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access. Deep PA/appeals/coverage knowledge; strong Medicare/Medicaid/commercial payer knowledge.
Pay/Benefits:
- $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long summer/winter shutdown), educational assistance/student loan repayment, commuting subsidy, charitable donation matching, and 401(k).
Application:
- Contact Talent Acquisition for application assistance at ApplicationAssistance@vrtx.com.
Field-based Field Reimbursement Manager for Vertex’s Kidney Patient Support Program (KPSP), serving as local subject matter expert to nephrology practices and supporting non-promotional access and reimbursement education to enable timely patient access to prescribed kidney therapies.
Key Duties and Responsibilities:
- Build compliant relationships with nephrology office personnel for prior authorization and patient access.
- Partner with case management to resolve escalated access issues; coordinate handoffs via CRM triggers/workflows.
- Educate offices on copay, PAP, Bridge programs, and other affordability pathways; provide follow-up on case status and insurance documentation requirements.
- Understand commercial and government prescription coverage requirements and payer trends.
- Conduct on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exception criteria, ICD-10/CPT and documentation, and distribution/hub/reimbursement workflows.
- Manage a multistate region, prioritize accounts, adapt to office workflows, and develop territory engagement plans to reduce access barriers.
- Follow non-promotional, compliance, privacy, and confidentiality requirements; apply program business rules for a consistent patient/customer experience.
Knowledge and Skills/Qualifications:
- Specialty biologics/rare disease or complex pharmacy benefit experience; account management with HCP offices.
- Payer portal/CRM navigation; strong communication/training/relationship-building.
- Analytical skills, data/reporting use to prioritize caseload; strategic planning experience.
- Travel 50–70%; proficiency in Outlook/Word/Excel/PowerPoint/Salesforce CRM.
- Valid driver’s license; meet healthcare representative credentialing requirements.
- Bachelor’s degree (health care/life sciences/business); 5+ years in sales/reimbursement/market access/specialty pharmacy/patient services/field access. Deep PA/appeals/coverage knowledge; strong Medicare/Medicaid/commercial payer knowledge.
Pay/Benefits:
- $136,000–$204,000; eligible for annual bonus and annual equity awards.
- Total Rewards include medical/dental/vision, paid time off (incl. week-long summer/winter shutdown), educational assistance/student loan repayment, commuting subsidy, charitable donation matching, and 401(k).
Application:
- Contact Talent Acquisition for application assistance at ApplicationAssistance@vrtx.com.