Top 26 Medicare sales representative Jobs in Springfield, Oh

Field Reimbursement Manager - Kidney (New England - ME, VT, NH, MA, RI, CT)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (Chicago, IL)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (IN-KY-TN)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (East Texas-Louisiana)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (Central Southwest - AZ, NM, TX, OK)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (NJ-MD-DE)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance
Field Reimbursement Manager - Kidney (Northern California - San Francisco, San Jose, Sacramento)
Vertex Pharmaceuticals —United States
- $136,000 - $204,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Loan repayment program
- Dental insurance

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Field Reimbursement Manager - Kidney (New England - ME, VT, NH, MA, RI, CT)

Vertex Pharmaceuticals -
United States

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Job Details

Full-time
$136,000 - $204,000 a year

Benefits

Loan repayment program
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching
Prescription drug insurance

Qualifications

Health insurance authorizations
Appeals
Customer training
Strategic management
Health insurance co-pays
Microsoft Excel
Customer relationship building
Microsoft Outlook
Medicare
5 years
Caseload management
Bachelor's degree in business
Coding for physician billing
Medical claim appeals
Client relationship development
Patient service
Medicaid health insurance
Salesforce Cloud
Analysis skills
Driver's License
Bachelor's degree
Medicare regulations
Driving
Decision making
Territory management
Sales territory planning
Sales management systems proficiency
Developing strategic business plans
Vendor communication
Data interpretation

Full Job Description

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.
Distribution pathways, hub services, enrollment processes, and reimbursement workflows.
Conduct on-site and virtual training using approved payer guides, checklists, access tools, and workflow maps.
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 and avoid introducing complexities or inefficiencies.
Develop territory engagement plans reflecting local payer landscapes and practice resources to help minimize patient-specific access barriers
Adhere to strict non‑promotional guidelines; all engagements must be compliant with relevant legal/compliance/privacy guardrails.
Maintain confidentiality of patient health information and act in compliance with all laws, regulations, and Vertex company policies
Apply program business rules and work instructions to deliver a consistent and compliant patient and customer experience.

Knowledge and Skills:

Experience working with specialty biologics, rare disease therapies, or complex pharmacy benefit products.
Account management experience, working directly with HCPs and office staff to navigate complex access challenges
Ability to navigate payer portals, CRM systems, and field access tools.
Strong communication, training, and relationship-building skills with provider office staff and internal PSP and vendor teams.
Strong analytical skills: ability to derive insights from customer and internal team engagements
Ability to leverage data and reporting tools to manage caseload and prioritize patient needs
Comfortable working in a fast-paced, results-driven environment within a growing business unit
Experience developing and executing strategic business/account plans
Demonstrated ability to facilitate appropriate judgment in decision making and problem solving
Ability to travel 50-70% within assigned territory.
Proficiency in Microsoft Outlook, Word, Excel, PowerPoint, Salesforce CRM
While the Company is usually closed on holidays, employees may be asked on occasion to work to meet organizational needs
Valid driver's license and ability to meet safe driving requirements
Ability to satisfy and meet all health care industry representative credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory

Education and Experience:

Bachelor’s degree in health care, life sciences or business field; advanced degree in business, healthcare, social services is a plus
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.

Pay Range:

$136,000 - $204,000

Disclosure Statement:

The range provided is based on what we believe is a reasonable estimate for the base salary pay range for this job at the time of posting. This role is eligible for an annual bonus and annual equity awards. Some roles may also be eligible for overtime pay, in accordance with federal and state requirements. Actual base salary pay will be based on a number of factors, including skills, competencies, experience, and other job-related factors permitted by law.

At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations. From medical, dental and vision benefits to generous paid time off (including a week-long company shutdown in the Summer and the Winter), educational assistance programs including student loan repayment, a generous commuting subsidy, matching charitable donations, 401(k) and so much more.

Company Information

Vertex is a global biotechnology company that invests in scientific innovation.

Vertex is committed to equal employment opportunity and non-discrimination for all employees and qualified applicants without regard to a person's race, color, sex, gender identity or expression, age, religion, national origin, ancestry, ethnicity, disability, veteran status, genetic information, sexual orientation, marital status, or any characteristic protected under applicable law. Vertex is an E-Verify Employer in the United States. Vertex will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.

Any applicant requiring an accommodation in connection with the hiring process and/or to perform the essential functions of the position for which the applicant has applied should make a request to the recruiter or hiring manager, or contact Talent Acquisition at [email protected]

Apply Now

Refine Your Search

medicare sales representative jobs in springfield, oh

Field Reimbursement Manager - Kidney (New England - ME, VT, NH, MA, RI, CT)

Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)

Field Reimbursement Manager - Kidney (Chicago, IL)

Field Reimbursement Manager - Kidney (IN-KY-TN)

Field Reimbursement Manager - Kidney (East Texas-Louisiana)

Field Reimbursement Manager - Kidney (Central Southwest - AZ, NM, TX, OK)

Field Reimbursement Manager - Kidney (NJ-MD-DE)

Field Reimbursement Manager - Kidney (Northern California - San Francisco, San Jose, Sacramento)

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