Field Reimbursement Manager - Kidney (Southeast - AL, GA, FL)

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 to provide non-promotional reimbursement/access education and troubleshoot to support timely patient access. Key Duties & Responsibilities: Build compliant relationships with nephrology office personnel involved in prior authorizations and patient access. Partner with case management on escalated access issues; use CRM triggers/workflows for handoffs. Educate offices on copay, PAP, Bridge programs, and affordability pathways. Follow up on case status and ensure offices understand insurance documentation requirements. Maintain knowledge of commercial and government insurance coverage requirements and payer trends. Conduct compliant on-site/virtual in-services covering payer policies, PA/medical exception criteria, ICD-10/CPT, documentation, distribution/hub services, enrollment, and reimbursement workflows. Independently manage a multistate territory; prioritize accounts based on patient need and payer dynamics. Develop territory engagement plans to minimize access barriers; follow strict non-promotional guidelines and maintain patient confidentiality. Knowledge & Skills: Specialty biologics/rare disease or complex pharmacy benefit experience; account management. Ability to navigate payer portals and CRM/tools; strong communication/training and analytical skills; data/reporting to manage caseload. Strategic account planning; sound judgment; travel 50–70%. Proficiency: Outlook/Word/Excel/PowerPoint/Salesforce. Valid driver’s license; meet healthcare representative credentialing requirements. Education & Experience: Bachelor’s degree (health care/life sciences/business). Minimum 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access. Deep understanding of benefits investigations, PA/appeals, coverage policies; payer knowledge (Medicare/Medicaid/commercial). Pay Range: $136,000–$204,000 (eligible for annual bonus and annual equity awards). #J-18808-Ljbffr