Patient Access Liaison Manager - Gainesville FL
About The Position
The Patient Access Liaison (PAL) is a field-based patient access and reimbursement specialist who supports patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies. The PAL helps stakeholders understand payer requirements, prior authorization processes, reimbursement considerations, and available patient support resources. The role focuses on enabling timely and sustained access to therapy by addressing reimbursement barriers and educating patients and providers about coverage and financial assistance programs. Working in a collaborative field environment, the PAL partners with internal teams including Market Access, Medical Affairs, Advocacy, Marketing, Case Management, and Site of Care teams to support the patient journey. The role independently manages assigned patient cases and contributes field insights that inform broader access strategies.
Responsibilities
- Serve as a resource on patient access and reimbursement for infused and specialty therapies.
- Help patients, caregivers, and healthcare providers navigate insurance benefits, prior authorization requirements, and reimbursement processes.
- Identify and help resolve access challenges, including coverage questions, prior authorization barriers, and denied claims.
- Educate stakeholders about 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 the 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 about 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 about 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 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.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
