Additional Information
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.
Vertex Pharmaceuticals · Boston, MA