Director, Field Reimbursement (Central)

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 passionate, dedicated, and collaborative Area Leader of Field Reimbursement to lead and manage a team of Field Reimbursement Managers (FRMs) to support non-promotional access and reimbursement to our kidney-related therapies. This role is pivotal in driving field reimbursement strategies, fostering cross-functional collaboration, and ensuring compliance with regulatory standards. The Area Leader will oversee the development and execution of regional strategies to address reimbursement challenges, enhancing patient access, and educating healthcare providers on payer landscapes.

The role is field-based and reports to the Kidney Patient Support Lead. Extensive travel within assigned area and nationally is required.

Key Duties and Responsibilities:

Team Leadership

• Lead and manage FRMs, providing strategic direction, coaching, and performance feedback.
• Conduct team meetings and facilitate best practice sharing to ensure team consistency, nurture collaboration, and drive continuous improvement.
• Participate in the recruitment, development, and retention of top talent, and travel within the assigned region to support team members, attend field calls, and engage with healthcare providers.
• Develop and manage budgets, travel, and team operations in compliance with company policies.

Strategic Execution

• Develop and execute regional field reimbursement strategies aligned with organizational goals and patient services objectives.
• Monitor and analyze regional and national trends in access, reimbursement, and patient support to proactively address barriers and develop long-term solutions.
• Develop and utilize data-driven, access-related insights to inform decision making.

Field Engagement

• Serve as a key point of contact for escalated issues related to patient access and reimbursement, working collaboratively with FRMs, market access, and patient support to resolve challenges.
• Enhance the patient experience via feedback, business insights, and continuous coaching of FRMs.  
• Develop strategies for FRM engagement that adapt to existing office workflows and avoid introducing complexity or inefficiencies.
• 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.

Operational Excellence

• Partner with external vendors and internal teams to ensure seamless patient access and support services, including the development of SOPs, training materials, and communication guides.
• Ensure compliance with company policies, industry regulations, and patient privacy guidelines, including HIPAA.

• Establish and track key performance indicators and performance metrics for the FRM team to ensure accountability and success.

Cross-Functional Collaboration

• Work closely with appropriate cross-functional partners to facilitate development of approved external communications regarding Patent Support Program information and updates.
• Develop strong working relationships with internal case management and specialty pharmacy teams to compliantly coordinate support for patients.
• Embody a culture of compliant cross-functional collaboration, serving as a business partner to internal Vertex stakeholders.

Education and Experience:

• Bachelor’s degree in a relevant field; advanced degree (MBA, MPH, MHA) preferred.
• Minimum of 10 years’ experience in market access, patient services, sales, or field reimbursement within the pharmaceutical or biotech industry.
• At least 5 years of experience leading a specialty/rare disease field reimbursement or patient access team.
• Proven experience in building and scaling case management, sales, access, or field reimbursement teams.
• Launch experience for specialty products.
• In-depth knowledge of payer landscapes, reimbursement processes, and specialty/rare disease products.
• Strong understanding of regulatory and compliance requirements, including HIPAA and patient pri