Vertex
Biotechnology
FieldReimbursementManagerKidney
“Field Reimbursement Manager - Kidney at Vertex. Skills: Reimbursement education, Patient access, Payer policies. Establish connections with key nephrology office personnel. Support patient access to prescribed medications”
Industry & Context.
Troubleshooting; Problem solving
Travel 50-70%, On-site education, Virtual education
What They're Looking For.
Must Have
Minimum 5+ years’ experience in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles, Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and payer ecosystems, Payer knowledge and in-depth understanding of Medicare, Medicaid, and commercial insurance plans, Valid driver's license, Ability to meet safe driving requirements, Ability to satisfy and meet all health care industry representative credentialing requirements
Nice to Have
Advanced degree in business, healthcare, social services is a plus
What You'll Do.
Establish connections with key nephrology office personnel
Support patient access to prescribed medications
Partner with case management team
Address escalated access issues
Ensure coordinated handoffs
Support timely patient access to Vertex medicine
Educate offices on affordability pathways
Provide timely follow-up on case status
Ensure offices understand insurance documentation requirements
Maintain understanding of commercial and government prescription insurance
Maintain understanding of payer trends
Conduct on-site and virtual in-services
Deliver compliant education on regional payer policies
Deliver education on formulary updates
Deliver education on coverage nuances
Deliver education on PA/medical exception criteria
Deliver education on coding/billing
Deliver education on documentation requirements
Deliver education on distribution pathways
Deliver education on hub services
Deliver education on enrollment processes
Deliver education on reimbursement workflows
Conduct on-site and virtual training
Independently manage a multistate geographic region
Prioritize accounts based on patient need
Prioritize accounts based on payer dynamics
Prioritize accounts based on KPSP demand
Adapt engagement with prescribing HCP offices
Develop territory engagement plans
Minimize patient-specific access barriers
Adhere to strict non-promotional guidelines
Maintain confidentiality of patient health information
Act in compliance with all laws
Act in compliance with regulations
Act in compliance with Vertex company policies
Apply program business rules
Apply work instructions
Deliver consistent patient experience
Deliver compliant customer experience
How You'll Work.
Team & Collaboration
Provider office staff; Internal PSP teams; Vendor teams
Communication Scope
Training; Relationship-building
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