Field Reimbursement Manager

Responsibilities

• Serve as a local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education.
• Establish strong connections with nephrology office personnel to support patient access to prescribed medications.
• Partner with case management teams to address escalated access issues and ensure coordinated workflows.
• Educate medical offices on copay, patient assistance programs (PAP), bridge programs, and other affordability pathways.
• Conduct on-site and virtual training regarding regional payer policies, formulary updates, coding/billing (ICD-10, CPT), and reimbursement workflows.
• Manage a multi-state geographic region, prioritizing accounts based on patient need and payer dynamics.
• Develop territory engagement plans to minimize patient-specific access barriers.

Requirements

• Bachelor’s degree in healthcare, life sciences, or business.
• Minimum 5+ years of experience in sales, reimbursement, market access, specialty pharmacy, or field-based access roles.
• Deep understanding of benefits investigations, prior authorization (PA) processes, appeals, and coverage policies.
• In-depth knowledge of Medicare, Medicaid, and commercial insurance plans.
• Experience working with specialty biologics, rare disease therapies, or complex pharmacy benefit products.
• Ability to travel 50-70% within the assigned territory.
• Valid driver's license and ability to meet safe driving requirements.

Preferred Qualifications

• Advanced degree in business, healthcare, or social services.
• Experience navigating payer portals, CRM systems (such as Salesforce), and field access tools.
• Proven ability to develop and execute strategic business and account plans.

Benefits

• Competitive base salary with eligibility for annual bonuses and equity awards.
• Comprehensive medical, dental, and vision benefits.
• Generous paid time off, including a week-long company shutdown in the summer and winter.
• Educational assistance and student loan repayment programs.
• 401(k) with company matching.

About the Company

Vertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company is dedicated to advancing therapies for life-shortening genetic diseases and continues to expand its clinical pipeline across various serious medical conditions.