Patient Access Liaison - Rare Disease - Central Job at Amgen (Chicago)

Job Description

The Patient Access Liaison (PAL) is a field-based patient access and reimbursement specialist responsible for supporting patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies.

Job Responsibility

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
OR Doctorate degree and 2 years of patient services, and/or access and reimbursement, experience
OR Master's degree and 4 years of patient services, and/or access and reimbursement, experience
OR Bachelor's degree and 6 years of patient services, and/or access and reimbursement, experience

Nice to have

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

What we offer

Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and 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 and bi-annual company-wide shutdowns
Flexible work models, including remote work arrangements, where possible

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Patient Access Liaison - Rare Disease - Central

Job Description

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