Job Overview
Compensation
Salary
Range $136,000.00 - $204,000.00
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Paid Time Off
Retirement Plan
educational assistance
Commuting subsidy
Job Description
Vertex is a leading global biotechnology company dedicated to scientific innovation and the development of transformative therapies. With a focus on serious and rare diseases, Vertex invests heavily in research and development to improve the lives of patients worldwide. The company values inclusion and equal opportunity, ensuring a diverse and dynamic workplace that fosters growth, collaboration, and cutting-edge solutions in the biotechnology space. Vertex supports its employees through comprehensive benefits and a commitment to work-life balance, offering competitive salaries, flexible work environments, and opportunities for professional advancement.
Vertex is currently expanding its Kidney Patient Support Program (KPSP) by building a specialized field reimbursement team. This initiative supports the company’s mission to advance, develop, and deliver therapies for serious kidney diseases, including Immunoglobulin A nephropathy (IgAN) and other genetic kidney and B cell-mediated disorders. The company is preparing for the commercialization of promising investigational therapies and is seeking a dedicated Field Reimbursement Manager to play a critical role in this effort.
The Field Reimbursement Manager will be a field-based expert providing crucial reimbursement and access education to nephrology practices. Acting as the local subject matter expert, this individual will establish and maintain strong relationships with key personnel in nephrology offices, including care teams and administrative staff responsible for insurance prior authorizations. By partnering with various internal teams, the role ensures patients gain timely and efficient access to prescribed Vertex kidney therapies.
This position requires a comprehensive understanding of commercial and government payer landscapes, including Medicare, Medicaid, and commercial insurance plans. The Field Reimbursement Manager will convey complex payer policies, formulary updates, and coverage nuances while maintaining strict adherence to compliance and privacy regulations. They will conduct educational in-services, manage a multistate geographic territory, develop strategic engagement plans, and troubleshoot access barriers using data-driven insights.
The role offers a competitive salary range of $136,000 to $204,000 per year, with eligibility for annual bonuses, equity awards, and some overtime pay where applicable. Vertex provides inclusive, market-leading benefits designed to support employees' career development, wellbeing, and personal needs, including paid time off, educational assistance, and retirement savings plans.
This is an ideal opportunity for experienced professionals with a background in specialty biologics, rare disease therapies, or complex pharmacy benefits, and a passion for making a difference in patient lives through access and reimbursement expertise. The Field Reimbursement Manager position demands a collaborative spirit, strong communication skills, strategic thinking, and a high level of professionalism to navigate the complexities of specialty medication access in a fast-paced, evolving business environment.
Vertex is currently expanding its Kidney Patient Support Program (KPSP) by building a specialized field reimbursement team. This initiative supports the company’s mission to advance, develop, and deliver therapies for serious kidney diseases, including Immunoglobulin A nephropathy (IgAN) and other genetic kidney and B cell-mediated disorders. The company is preparing for the commercialization of promising investigational therapies and is seeking a dedicated Field Reimbursement Manager to play a critical role in this effort.
The Field Reimbursement Manager will be a field-based expert providing crucial reimbursement and access education to nephrology practices. Acting as the local subject matter expert, this individual will establish and maintain strong relationships with key personnel in nephrology offices, including care teams and administrative staff responsible for insurance prior authorizations. By partnering with various internal teams, the role ensures patients gain timely and efficient access to prescribed Vertex kidney therapies.
This position requires a comprehensive understanding of commercial and government payer landscapes, including Medicare, Medicaid, and commercial insurance plans. The Field Reimbursement Manager will convey complex payer policies, formulary updates, and coverage nuances while maintaining strict adherence to compliance and privacy regulations. They will conduct educational in-services, manage a multistate geographic territory, develop strategic engagement plans, and troubleshoot access barriers using data-driven insights.
The role offers a competitive salary range of $136,000 to $204,000 per year, with eligibility for annual bonuses, equity awards, and some overtime pay where applicable. Vertex provides inclusive, market-leading benefits designed to support employees' career development, wellbeing, and personal needs, including paid time off, educational assistance, and retirement savings plans.
This is an ideal opportunity for experienced professionals with a background in specialty biologics, rare disease therapies, or complex pharmacy benefits, and a passion for making a difference in patient lives through access and reimbursement expertise. The Field Reimbursement Manager position demands a collaborative spirit, strong communication skills, strategic thinking, and a high level of professionalism to navigate the complexities of specialty medication access in a fast-paced, evolving business environment.
Job Requirements
- Bachelor’s degree in healthcare, life sciences, or business field
- Minimum 5 years’ experience in relevant sales, reimbursement, or access roles
- Proven knowledge of specialty biologics and rare disease therapies
- Strong understanding of payer portals and CRM systems
- Ability to travel 50-70% within assigned territory
- Valid driver’s license with ability to meet safe driving requirements
- Ability to satisfy healthcare industry representative credentialing requirements for assigned territory
- Strong communication and analytical skills
- Ability to work in a fast-paced, results-driven environment
- Adherence to non-promotional compliance and privacy policies
- Willingness to occasionally work on holidays to meet organizational needs
Job Qualifications
- Bachelor’s degree in healthcare, life sciences, or business field
- Minimum 5 years’ experience in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles
- Deep understanding of benefits investigations, prior authorization processes, appeals, coverage policies, and payer ecosystems
- Payer knowledge and in-depth understanding of Medicare, Medicaid, and commercial insurance plans
- Experience working with specialty biologics, rare disease therapies, or complex pharmacy benefit products
- Account management experience navigating complex access challenges with HCPs and office staff
- Ability to navigate payer portals, CRM systems, and field access tools
- Strong communication, training, and relationship-building skills
- Strong analytical skills with ability to derive insights from customer and internal team engagements
- Ability to leverage data and reporting tools to manage caseload and prioritize patient needs
- Experience developing and executing strategic business or account plans
- Demonstrated sound judgment and problem-solving skills
- Proficiency in Microsoft Outlook, Word, Excel, PowerPoint, Salesforce CRM
Job Duties
- Compliantly establish strong connections with key nephrology office personnel including care teams and administrative staff responsible for prior authorizations and patient access to specialty medications
- Partner with case management team to address escalated access issues and ensure coordinated handoffs using CRM triggers and workflows
- Support timely patient access to prescribed Vertex medicines 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 comprehensive understanding of commercial and government prescription insurance coverage requirements and payer trends
- Conduct on-site and virtual in-services delivering compliant education on regional payer policies, formulary updates, coverage nuances, PA/medical exception criteria, coding/billing, documentation requirements, distribution pathways, hub services, enrollment processes, and reimbursement workflows
- Independently manage a multistate geographic region prioritizing accounts based on patient need, payer dynamics, and KPSP demand
- Adapt engagement with prescribing HCP offices based on existing office workflows avoiding complexities or inefficiencies
- Develop territory engagement plans reflecting local payer landscapes and practice resources to minimize patient-specific access barriers
- Adhere to strict non-promotional guidelines ensuring all engagements comply with legal, compliance, and privacy guardrails
- Maintain confidentiality of patient health information and comply with all laws, regulations, and company policies
- Apply program business rules and work instructions to deliver consistent and compliant patient and customer experience
Job Criteria
Experience
Mid Level (3-7 years)
Job Location
Your Profile Is Visible To Hiring Managers Across OysterLink.
We'll match you with best jobs
Get job offers faster
Search For More Opportunities:
How Candidates Get Hired Faster
Apply to 2–3 similar roles
Complete profile & get best matches
Check new opportunities daily
