Patient Access Liaison- TEPEZZA- Cincinnati, OH

Amgen•Cincinnati, OH

8d•$158,394 - $222,256

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 role helps stakeholders understand payer requirements, prior authorization processes, reimbursement considerations, and patient support resources, with the goal of addressing reimbursement barriers and supporting timely, sustained access to therapy. The PAL independently manages assigned patient cases and collaborates with internal teams including Market Access, Medical Affairs, Advocacy, Marketing, Case Management, and Site of Care teams. The position also shares field insights to inform broader access strategies. Travel may be up to 50%, including occasional overnight and weekend commitments.

Requirements

Level 5: 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 such experience; or associate’s degree and 8 years of such experience; or high school diploma/GED and 10 years of such experience.
Level 6: Doctorate degree and 2 years of patient services and/or access and reimbursement experience; or master’s degree and 4 years of such experience; or bachelor’s degree and 6 years of such experience.
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.

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.
Knowledge of prior authorization processes.
Knowledge of healthcare reimbursement systems.
Coding and billing awareness.
Patient support program knowledge.
Knowledge of compliance and privacy requirements.
Learning agility.
Decision quality.
Stakeholder engagement.

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.
Provide education on 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 on 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 on common prior authorization requirements, coding considerations, and billing practices.
Support healthcare providers and infusion centers with 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.

Benefits

Health and welfare plans for staff and eligible dependents.
Financial plans with opportunities to save toward retirement or other goals.
Work/life balance and career development opportunities.
Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions.
Group medical, dental, and vision coverage.
Life and disability insurance.
Flexible spending accounts.
Discretionary annual bonus program, or a sales-based incentive plan for field sales representatives.
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.