Patient Access Liaison - Rare Disease - Central

Amgen•Iowa City, IA

1d•$158,394 - $222,256•Remote

About The Position

Amgen is seeking a Patient Access Liaison (PAL) to join their Corporate Services team. The PAL is a field-based specialist responsible for assisting patients, caregivers, healthcare providers, and sites of care in navigating insurance coverage and reimbursement pathways for Amgen therapies. This role focuses on ensuring timely access to treatment by addressing reimbursement barriers, educating stakeholders on coverage and financial assistance programs, and resolving access challenges. The PAL will collaborate with internal teams such as Market Access, Medical Affairs, Advocacy, Marketing, Case Management, and Site of Care teams, while operating independently to manage patient cases and provide valuable field insights.

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 (for Level 5)
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 (for Level 6)
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 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.