FieldReimbursementManager-Kidney(NYCMetro)

**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. * Partner with case management team to address escalated access issues; ensure coordinated handoffs using CRM triggers and workflows. * Support timely patient access to their prescribed Vertex medicine by educating offices on copay, PAP, Bridge programs, and other affordability pathways. * Provide timely follow-up on case status and ensure offices understand insurance documentation requirements. * Maintain a comprehensive understanding of commercial and government prescription insurance coverage requirements for access and payer trends. * Conduct on-site and virtual in-services to deliver compliant and comprehensive education on: * Regional payer policies, formulary updates, and coverage nuances. * PA/medical exception criteria, coding/billing (ICD‑10, CPT), and documentation requirements