Regional Access & Reimbursement Associate Director

Role Summary

Regional Access & Reimbursement Associate Director will help ensure appropriate access and reimbursement of Vertex cellular and genetic therapies within an assigned geography in close collaboration with US Market Access functions, US Public Affairs, Field HEOR, Patient Support, Account Management/sales and Marketing. The individual will build relationships to ensure patient access and resolve reimbursement challenges, serving as the state/regional expert on reimbursement (coding, coverage, payment). Develops and maintains regional/account business plans and provides insights on coding, payer coverage policy developments, reimbursement, contracting trends, and competitive activity.

Responsibilities

• Partner with internal stakeholders across functions to develop and achieve targeted plans of action.
• Manage objectives and priorities across multiple therapeutic areas.
• Collaborate with field payer teams on coverage policy developments and coding education.
• Develop and maintain geographic and account business plans.
• Establish relationships with key institution/hospital personnel responsible for access, coding, billing, reimbursement and financial clearance.
• Provide reimbursement-related support and education to secure access for new procedures and therapies.
• Coordinate reimbursement pull-through by educating on managed care and government payer coverage policies, billing and coding requirements, Medicare/State Medicaid methodologies, prior authorization, claims submission, and appeals processes.
• Educate on trade and distribution; ensure adoption and implementation of newly issued codes; track local payer requirements.
• Lead cross-functional challenge resolution processes; interface with Patient Support as appropriate.
• Travel overnight and on weekends as needed, at least 60% within assigned geography.
• Maintain compliance with SOPs and guidelines.

Qualifications

• Bachelor‚Äôs degree required; Master‚Äôs/Advanced degree preferred.
• Typically 8+ years of experience or equivalent combination of education and experience.
• Current experience in cell and gene therapy access and reimbursement preferred.
• Demonstrated experience in field reimbursement or hospital administration with ability to solve reimbursement challenges in hospital/institution inpatient settings.

Knowledge and Skills

• Ability to work in a fast-paced environment, manage multiple priorities, and collaborate across functions.
• Excellent analytical, strategic thinking, and communication skills.
• Expertise in US market access across commercial payers, Medicaid/Medicare, hospitals/health systems, benefit designs, and reimbursement methodologies.
• Expertise in inpatient hospital access and reimbursement requirements by department and hospital economics.
• Expertise in hospital financial and operational processes.

Education

• Bachelor‚Äôs degree in relevant field required; Master‚Äôs/Advanced degree preferred.

Location

• Field Based, Southern and Southeast States