Vertex Pharmaceuticals · 19 hours ago
Regional Access & Reimbursement Associate Director
Greater Wilmington Area
Full-time
Hybrid
Senior Level, Lead/Staff
$160K/yr - $240K/yr
8+ years expVertex Pharmaceuticals is at the forefront of scientific innovation, having developed multiple breakthrough medicines. The Regional Access and Reimbursement Associate Director will ensure appropriate access and reimbursement for Vertex therapies by building relationships and collaborating with various stakeholders in the healthcare sector.
BiotechnologyHealth CareMedicalPharmaceutical
Responsibilities
Appropriately partners with internal stakeholders across functions (Payer Accounts, State Government Affairs, Trade and Distribution, Hospital Account Managers, Marketing, Patient Support) to develop and achieve targeted plans of action
Effectively manages objectives and priorities across multiple therapeutic areas
Collaborates closely with field payer teams on coverage policy developments and coding education
Develops and maintains geographic and account business plans
Establishes relationships with key institution/hospital personnel: C-Suite, Operations, Revenue Cycle Management, Finance, Managed Care, and other stakeholders responsible for access, coding, billing, reimbursement and overall financial clearance
Provides reimbursement-related support and education (Hospital Economics, Coding, Billing, Payment, Policy, Processes) to secure access for new procedures and therapies
Coordinates comprehensive reimbursement pull-through by proactively engaging with institution/hospital personnel to educate on:
Managed care and government payer coverage policies
Billing and coding requirements
Medicare and State Medicaid reimbursement methodologies
Prior Authorization and medical exception processes
Claims submission and appeals processes
Trade and Distribution
Ensures appropriate adoption and implementation of newly issued codes
Tracks all local payer billing, coding, and claims submission requirements
Leads cross-functional challenge resolution processes including interfacing with Patient Support as appropriate
Requires overnight and weekend travel to attend internal meetings, conferences and at least 80% within assigned geography
Maintains compliance with Vertex SOPs and guidelines
Qualification
Required
Bachelor's degree in relevant field required
Typically requires 8 or more years of experience or the equivalent combination of education and experience
Ability to perform in a fast-paced environment, manage multiple priorities simultaneously, and work effectively across functional teams
Excellent analytical, strategic thinking and communication skills
Expertise in the US market access environment across Commercial Payers, managed and fee-for-service segments of Medicaid/Medicare, Hospitals/health systems, benefit designs, coverage policies and reimbursement methodologies
Expertise in the institution/hospital inpatient setting related to access and reimbursement requirements by department and overall hospital economics
Expertise in hospital financial and operational processes
Requires overnight and weekend travel to attend internal meetings, conferences and at least 80% within assigned geography
Maintains compliance with Vertex SOPs and guidelines
Preferred
Master's/Advanced degree preferred
Current experience in cell and gene therapy access and reimbursement preferred
Demonstrated experience in a field reimbursement or hospital administration role with demonstrated ability to problem solve reimbursement challenges within Hospital/Institution inpatient setting
Benefits
Medical, dental and vision benefits
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)
Company
Vertex Pharmaceuticals
Vertex Pharmaceuticals is focused on the discovery and development of small molecule drugs for the treatment of serious diseases.
5001-10000 employees
H1B Sponsorship
Vertex Pharmaceuticals has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (188)
2024 (150)
2023 (111)
2022 (164)
2021 (112)
2020 (80)
Funding
Current Stage
Public CompanyTotal Funding
$657.31MKey Investors
Janssen Belgium
2024-07-10Post Ipo Secondary· $1.11M
2022-05-17Post Ipo Equity· $50M
2009-12-03Post Ipo Equity· $443M
Leadership Team
Reshma Kewalramani
CEO and President
Nina Devlin
Senior Vice President, Chief Communications Officer
Recent News
2026-01-05
Company data provided by crunchbase