Job Description

General Summary:

The Senior Patient Support Specialist (SPSS) provides expert, end-to-end treatment support for people living with cystic fibrosis (CF) prescribed a Vertex medication, serving as the primary point of contact across the treatment journey for aligned patients and healthcare providers (HCPs). This role operates with a high degree of autonomy and judgment.

The SPSS applies deep expertise in access, reimbursement, financial assistance, and adherence support to navigate complex, multi-step access scenarios beyond treatment fulfillment, spanning the duration of the treatment. The role collaborates with patients, CF care teams, specialty pharmacies, vendors, and internal stakeholders to anticipate and remove access and adherence barriers, including those that are ambiguous or unprecedented.

As a recognized subject matter expert, the PSS elevates patient and HCP experiences, contributes to continuous improvement across GPS, and models behaviors aligned with Vertex values and compliance standards.

Key Duties & Responsibilities

Patient Access, Reimbursement & Financial Navigation

• Owns a dedicated caseload of CF patients; serves as the primary point of contact for patients and HCPs from onboarding through fulfillment and ongoing therapy.
• Resolves complex access/reimbursement scenarios across payers (commercial and government), specialty pharmacies, BI/CPA vendors, and financial assistance programs, inclusive of assessing patient eligibility for the co-pay and PAP.
• Leverages payer requirements, center workflows, and program resources to remove barriers and support timely access.
• Builds and executes prioritized case plans using operational tools and data to focus effort where impact is greatest.
• Uses approved work instructions and judgment to navigate novel scenarios; escalates appropriately and communicates clear next steps.

Adherence Support, Education & Sustained Engagement

• Builds trusted relationships with patients, caregivers, and HCPs through empathetic, adaptable, and compliant communication.
• Identifies adherence risks and tailors outreach cadence and channels based on patient context, preferences, barriers, and stage of therapy.
• Provides advanced CF and CFTR modulator education within approved guidance; supports informed decision-making and sustained engagement.
• Prepares for patient interactions, documents thoroughly, and completes timely follow-up to support continuity of care.

Strategic Planning, Collaboration & GPS Capability Advancement (15–20%)

• Compliantly collaborates with cross-functional stakeholders to anticipate access needs and apply insights to territory-level planning.
• Serves as an internal SME; shares compliant best practices, surfaces process gaps, and provides actionable feedback through appropriate channels.
• Builds internal and external networks to enable alignment, collaboration, and effective problem-solving.

Success Measures

• Reduced time from enrollment to first dispense through payer/pharmacy/vendor coordination.
• Ensures consistent compliant documentation and communication, including appropriate escalation and follow-through.
• Improved continuity of therapy as prescribed through adherence risk identification, tailored education, and sustained engagement.
• Effective resolution of complex access scenarios (e.g., PA/appeals, coverage changes) with clear stakeholder updates.
• Clear communication of payer/center/process trends that inform team practices and continuous improvement.

Professional Behaviors & Expectations

• Maintains knowledge of approved CFTR modulator treatments and supplemental assistance programs to provide exceptional support to GPS enrolled patients and families
• Develops and maintains a strategic business plan for supporting their CF patients within the assigned territory; utilizes analytics tools to proactively monitor and, anticipate patient needs and rapidly responds to trends
• Demonstrates advanced access/navigation expertise, addressing complex barriers while operating within approved guidance and compliance standards.
• Plans and prioritizes work using market knowledge, data, and operational tools; adapts quickly as patient or payer situations change.
• Operates with an enterprise, “We Win” mindset—leveraging collective expertise, supporting shared decisions, and raising concerns respectfully.
• Invests in continuous learning, incorporates feedback, and shares insights to strengthen team capability.

Qualifications

• 3–4+ years of relevant experience (or equivalent combination of education and experience).
• Experience supporting patients within cystic fibrosis and/or rare disease communities; comfort navigating sensitive situations and difficult conversations.
• Expertise in access and reimbursement navigation across commercial and government payers, including benefit investigations, prior authorizations, and appeals.
• Proven track record creating and executing strategic caseload business plans
• Patient support and/or case management experience (pharmaceutical/biotechnology preferred); demonstrated success managing complex cases and partnering with multidisciplinary clinical teams.
• Working knowledge of healthcare compliance and the broader regulatory environment.
• Excellent verbal and written communication; sound judgment, problem-solving, and ability to work independently while prioritizing a dynamic workload.

Other Requirements

• Proficiency in Microsoft Outlook, Word, Excel, PowerPoint, Salesforce CRM, or similar systems.
• Willingness and ability to travel up to 15%, including occasional evenings or weekends.
• Experience applying Motivational Interviewing techniques (preferred)
• Fluency in Spanish (optional). Medical interpreter certification (optional).

Correct Pay Range:

$34/hour - $43/hour

Pay Range:

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.

Flex Designation:

Flex Eligibility Status:

In this Hybrid-Eligible role, you can choose to be designated as:
1. Hybrid: work remotely up to two days per week; or select
2. On-Site: work five days per week on-site with ad hoc flexibility.

Note: The Flex status for this position is subject to Vertex’s Policy on Flex @ Vertex Program and may be changed at any time.

#LI-Hybrid

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]