Patient Access Liaison KRYSTEXXA - Savannah GA

Military Spouse Corporate Career Network•Savannah, GA

1d•Onsite

About The Position

In this vital role you will provide logistical, non-medical educational assistance to patients and caregivers as well as office and site of care staff, including physicians, nurses, office managers and executives. The PAL works in a highly visible, strong team environment to provide exceptional customer service on all levels. Specifically, listen to patients, interpreting their specific needs and providing friendly, professional and well-informed answers to their non-medical, logistical questions. The PAL will work with the patient to educate on next steps required to gain access to therapy. The PAL will also work to maintain relationships with patients and families, and by extension physicians and their staff and cross-functional partners to support ongoing compliance with therapy. Strong knowledge and demonstrated history of access and reimbursement for buy and bill/infused pharmaceutical products is required. The PAL will work with numerous internal teams, including Market Access, Medical Affairs, Advocacy, Marketing, and Site of Care to facilitate and improve patient access to insurance, medications, financial support, resources and more.

Requirements

Strong knowledge and demonstrated history of access and reimbursement for buy and bill/infused pharmaceutical products is required.
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)

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

Secure written or electronic HIPAA consent to Amgen By Your Side for patients in the assigned geography
Develop relationships with patients and caregivers by engaging via phone, text, email, virtual or in person connections
Assess individual needs of the patient and develop an appropriate education and resource plan of action, considering the patient’s family and team of healthcare providers to empower the patient to become their own advocate
Educate the patient on KRYSTEXXA coverage based on their benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Provide information on co-pay assistance programs, national foundations, and free drug programs by sharing information to patients as appropriate and needed
Provide proactive education to prescribers and sites of care upon patient enrollment on coverage for Amgen rare disease therapies, common prior authorization requirements, and coding and billings requirements
Provide access and reimbursement education based on the enrolled patient’s KRYSTEXXA benefits to physician offices and sites of care
Educate the physician office and/or SOC on KRYSTEXXA coverage based on the patient’s benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Investigate access challenges pre and post-infusion
Partner with Safety and PV and report AE’s and product complaints through medical information.
Work closely with the Amgen cross functional team including Case Managers, the Site of Care team, market access, matrix partners and external vendors
Adhere to professional standards compliance guidance, policies and procedures, federal, state, and local requirements