Bilingual Senior Patient Support Specialist

General/Position Summary

Key Duties & Responsibilities

Reimbursement & Access: (60%)

• Develops and maintains a strategic business plan for supporting their CF patients; utilizes analytics tools to proactively monitor medication schedules and anticipate patient needs to rapidly respond to trends

• Leverages insurance access and reimbursement expertise to counsel HCPs on coverage requirements

• Manages multiple complex access and reimbursement challenges to completion in a time-sensitive fast-paced environment

• Effectively escalates access vendor and pharmacy challenges keeping appropriate stakeholders informed

• Maintains a comprehensive understanding of commercial and government prescription insurance coverage requirements for access and payer trends

• Assesses patient eligibility for Vertex financial assistance programs including copay and patient assistance programs; advises on complex and sensitive financial circumstances

Adherence & Education: (25%)

• Sustains knowledge of approved CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) modulator treatments and supplemental assistance programs to provide exceptional patient support

• Anticipates and pursues opportunities throughout the treatment journey to provide Vertex treatment education and resources to mitigate adherence barriers

• Maintains strong working relationships with external partners including HCPs HUB vendor Specialty Distributors and Specialty Pharmacies to maintain/increase adherence rates

• Maintains patient records and interactions in CRM; provides refill reminders and scheduling support to patients; ensures delivery management and monitoring of the treatment refill process

• Maintains confidentiality of patient health information and acts in compliance with all laws regulations and Vertex Company policies.

• Demonstrates fluency and agility in supporting both Spanish and English patients

Strategic planning & advancing GPS team capabilities: (15%)

• Creates a culture of compliant cross-functional collaboration serving as a business partner to internal Vertex stakeholders such as sales and field reimbursement teams

• Interacts with sales marketing patient advocacy payer teams information technology and similar teams to provide excellent patient journey experience.

Required Experience

• Experience in payer reimbursement (including benefit investigations prior authorizations and appeals)

• Experience in patient support and/or case management (Pharmaceutical or biotechnology preferred)

• Working knowledge of healthcare compliance and regulatory environment

• Excellent verbal and written communication skills

• High level of empathy experience navigating difficult conversations

• Ability to facilitate appropriate judgment in decision making and solve difficult and complex problems

• Capability to work independently with limited supervision multitask and self-prioritize workload and demonstrate high level of agility

• Fluency in Spanish and English

Other Requirements

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.