Patient Access Liaison, Manager – Rare Disease
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Job Description
Field-based patient access liaison at Amgen supporting therapy access and reimbursement for patients. Collaborating with healthcare providers to navigate insurance coverage and support patient needs.
Responsibilities:
- Serve as a resource on patient access and reimbursement for infused and specialty therapies.
- Assist patients, caregivers, and healthcare providers in navigating insurance benefits, prior authorization requirements, and reimbursement processes.
- Support the identification and resolution of access challenges, including coverage questions, prior authorization barriers, and denied claims.
- Provide education regarding coding and billing considerations relevant to therapy access.
- Develop relationships with patients and caregivers through phone, virtual, and in-person engagement.
- Secure written or electronic patient HIPAA authorization within assigned geography.
- Assess individual patient needs and provide education and resources that support access to therapy.
- Educate patients on coverage considerations and the steps required to obtain prior authorization.
- Provide information regarding co-pay assistance programs, national foundations, and free drug programs when appropriate.
- Educate physician offices and sites of care on therapy coverage pathways and reimbursement processes.
- Provide information regarding common prior authorization requirements, coding considerations, and billing practices.
- Support healthcare providers and infusion centers in navigating reimbursement questions related to patient cases.
- Investigate patient access challenges before and after infusion.
- Support physician offices and sites of care in reviewing denied claims and identifying potential next steps.
- Escalate complex or systemic reimbursement issues to appropriate internal stakeholders.
- Partner with internal stakeholders including Market Access, Medical Affairs, Advocacy, Case Managers, and Site of Care teams to support patient access initiatives.
- Coordinate with internal and external partners to ensure appropriate resources are available to support patient access.
- Share field insights regarding payer policies and reimbursement challenges.
- Adhere to company policies, compliance guidance, and applicable to federal, state, and local regulations.
- Ensure activities align with HIPAA privacy requirements and internal compliance guidelines.
- Report adverse events and product complaints through established pharmacovigilance processes.
- Maintain accurate documentation of activities and interactions in Amgen’s internal system.
Requirements:
- Doctorate degree OR Master’s degree and 2 years of patient services and/or access and reimbursement experience OR Bachelor’s degree and 4 years of patient services and/or access and reimbursement experience OR Associate’s degree and 8 years of patient services and/or access and reimbursement experience OR High school diploma / GED and 10 years of patient services and/or access and reimbursement experience
- Experience supporting buy-and-bill or infused pharmaceutical therapies
- Rare disease or orphan drug experience
- Clinical background such as nursing or allied health
- Understanding of reimbursement processes including prior authorization, appeals, and denied claims management
- Knowledge of HIPAA guidelines and FDA regulatory requirements
- Familiarity with internal and OIG compliance guidelines
- Strong analytical and problem-solving skills
- Excellent written and verbal communication skills
- Ability to manage complex patient situations and resolve access barriers
- Experience working in cross-functional field teams
- Proficiency in Microsoft Office, CRM, AI and relevant systems
- Access and reimbursement knowledge
- Prior authorization processes
- Healthcare reimbursement systems
- Coding and billing awareness
- Patient support program knowledge
- Compliance and privacy requirements
- Learning agility
- Decision quality
- Stakeholder engagement
- Ability to respond rapidly to urgent access needs to prevent treatment delays or lapses
- Ability to operate effectively in matrix field environments
- Travel up to 50%, including occasional overnight and weekend commitments.
Benefits:
- A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions
- Group medical, dental and vision coverage
- Life and disability insurance
- Flexible spending accounts
- A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
- Stock-based long-term incentives
- Award-winning time-off plans
- Flexible work models where possible.
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