Patient Access Liaison, Manager - Krystexxa - Jacksonville FL (Rare Disease)

Amgen • Gainesville, FL

22h • $158,718 - $193,988 • Remote

About The Position

The Patient Access Liaison, Manager 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. The PAL Manager serves as a key resource in helping stakeholders understand payer requirements, prior authorization processes, reimbursement considerations, and available patient support resources. The role focuses on ensuring timely and sustained access to therapy by addressing reimbursement barriers and providing education to patients and providers on coverage and financial assistance programs. Working within a collaborative field environment, the PAL Manager 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 operates with independence in managing assigned patient cases and contributes field insights that inform broader access strategies.

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

Nice To Haves

• 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

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.

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, 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
• Flexible work models where possible

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees