Job Description General Summary:

Vertex is currently building a field reimbursement team to support our upcoming journey to advance, develop, and deliver therapies to those living with serious kidney diseases. We are preparing for potential commercialization of investigational therapeutics being studied for the treatment of Immunoglobulin A nephropathy (IgAN), additional B cell-mediated diseases, and other genetic kidney diseases. We are seeking a dedicated and collaborative Field Reimbursement Manager to join our Kidney Patient Support Program (KPSP). In this field-based role, you will serve as the local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education. You will also support timely access for patients to prescribed Vertex kidney therapies through effective troubleshooting and territory-level payer expertise.

Key Duties and Responsibilities:

Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications.\nPartner with case management team to address escalated access issues; ensure coordinated handoffs using CRM triggers and workflows.\nSupport timely patient access to their prescribed Vertex medicine by educating offices on copay, PAP, Bridge programs, and other affordability pathways.\nProvide timely follow-up on case status and ensure offices understand insurance documentation requirements.\nMaintain a comprehensive understanding of commercial and government prescription insurance coverage requirements for access and payer trends.\nConduct on-site and virtual in-services to deliver compliant and comprehensive education on:\nRegional payer policies, formulary updates, and coverage nuances.\nPA/medical exception criteria, coding/billing (ICD10, CPT), and documentation requirements.\nDistribution pathways, hub services, enrollment processes, and reimbursement workflows.\nConduct on-site and virtual training using approved payer guides, checklists, access tools, and workflow maps.\nIndependently manage a multistate geographic region, prioritizing accounts based on patient need, payer dynamics, and KPSP demand.\nAdapt engagement with prescribing HCP offices based on existing office workflows and avoid introducing complexities or inefficiencies.\nDevelop territory engagement plans reflecting local payer landscapes and practice resources to help minimize patient-specific access barriers\nAdhere to strict nonpromotional guidelines; all engagements must be compliant with relevant legal/compliance/privacy guardrails.\nMaintain confidentiality of patient health information and act in compliance with all laws, regulations, and Vertex company policies\nApply program business rules and work instructions to deliver a consistent and compliant patient and customer experience.

Knowledge and Skills:

Experience working with specialty biologics, rare disease therapies, or complex pharmacy benefit products.\nAccount management experience, working directly with HCPs and office staff to navigate complex access challenges\nAbility to navigate payer portals, CRM systems, and field access tools.\nStrong communication, training, and relationship-building skills with provider office staff and internal PSP and vendor teams.\nStrong analytical skills: ability to derive insights from customer and internal team engagements\nAbility to leverage data and reporting tools to manage caseload and prioritize patient needs\nComfortable working in a fast-paced, results-driven environment within a growing business unit\nExperience developing and executing strategic business/account plans\nDemonstrated ability to facilitate appropriate judgment in decision making and problem solving\nAbility to travel 50-70% within assigned territory.\nProficiency in Microsoft Outlook, Word, Excel, PowerPoint, Salesforce CRM\nWhile the Company is usually closed on holidays, employees may be asked on occasion to work to meet organizational needs\nValid driver's license and ability to meet safe driving requirements\nAbility to satisfy and meet all health care industry representative credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory

Education and Experience:

Bachelor's degree in health care, life sciences or business field; advanced degree in business, healthcare, social services is a plus\nMinimum 5+ years' experience in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles.\nDeep understanding of benefits investigations, PA processes, appeals, coverage policies, and payer ecosystems.\nPayer knowledge and in-depth understanding of Medicare, Medicaid, and commercial insurance plans.

Pay Range:

$136,000 - $204,000

Disclosure Statement:

The range provided is based on what we believe is a reasonable estimate for the base salary pay range for this job at the time of posting. This role is eligible for an annual bonus and annual equity awards. Some roles may also be eligible for overtime pay, in accordance with federal and state requirements. Actual base salary pay will be based on a number of factors, including skills, competencies, experience, and other job-related factors permitted by law. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations. From medical, dental and vision benefits to generous paid time off (including a week-long company shutdown in the Summer and the Winter), educational assistance programs including student loan repayment, a generous commuting subsidy, matching charitable donations, 401(k) and so much more. Company Information Vertex is a global biotechnology company that invests in scientific innovation. Vertex is committed to equal employment opportunity and non-discrimination for all employees and qualified applicants without regard to a person's race, color, sex, gender identity or expression, age, religion, national origin, ancestry, ethnicity, disability, veteran status, genetic information, sexual orientation, marital status, or any characteristic protected under applicable law. Vertex is an E-Verify Employer in the United States. Vertex will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law. 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