Patient Access Liaison, Manager – Rare Disease

This is a fully remote position, open to applicants in Florida.

📋 Description

• Assist patients, caregivers, healthcare providers, and care sites in navigating insurance coverage and reimbursement pathways for Amgen therapies.

• Clarify payer requirements, prior authorization procedures, reimbursement considerations, and patient support resources.

• Tackle reimbursement obstacles and inform patients and providers about coverage and financial assistance programs.

• Collaborate with Market Access, Medical Affairs, Advocacy, Marketing, Case Management, and Site of Care teams.

• Act as a resource for patient access and reimbursement concerning infused and specialty therapies.

• Aid in understanding insurance benefits, prior authorization needs, and reimbursement processes.

• Identify and resolve inquiries about coverage, prior authorization hurdles, and denied claims.

• Provide education on coding and billing considerations.

• Build relationships with patients and caregivers through phone, virtual, and in-person interactions.

• Obtain written or electronic HIPAA authorization within the designated geography.

• Evaluate patient needs and deliver education and access resources.

• Share information on co-pay assistance, national foundations, and free drug programs.

• Educate physician offices and care sites about therapy coverage pathways and reimbursement processes.

• Investigate patient access issues before and after infusion.

• Review denied claims and determine potential next steps.

• Elevate complex or systemic reimbursement challenges to internal stakeholders.

• Coordinate with internal and external partners to ensure necessary resources are accessible.

• Provide field insights regarding payer policies and reimbursement challenges.

• Comply with company policies, compliance guidelines, and federal, state, and local regulations.

• Ensure adherence to HIPAA privacy requirements.

• Report adverse events and product complaints through pharmacovigilance protocols.

• Maintain precise documentation in Amgen’s internal system.

⛳️ Requirements

• Doctorate degree; OR Master’s degree with 2 years of patient services and/or access and reimbursement experience; OR Bachelor’s degree with 4 years of patient services and/or access and reimbursement experience; OR Associate’s degree with 8 years of patient services and/or access and reimbursement experience; OR High school diploma/GED with 10 years of experience in patient services and/or access and reimbursement (Level 5).

• Doctorate degree with 2 years of patient services and/or access and reimbursement experience; OR Master’s degree with 4 years of patient services and/or access and reimbursement experience; OR Bachelor’s degree with 6 years of patient services and/or access and reimbursement experience (Level 6).

• Experience in supporting buy-and-bill or infused pharmaceutical therapies.

• Background in rare diseases or orphan drugs.

• Clinical experience, such as nursing or allied health.

• Knowledge of reimbursement processes, including prior authorization, appeals, and management of denied claims.

• Familiarity with HIPAA guidelines and FDA regulatory requirements.

• Understanding of internal and OIG compliance guidelines.

• Strong analytical and problem-solving capabilities.

• Excellent written and verbal communication skills.

• Ability to manage complex patient situations and overcome access barriers.

• Experience in cross-functional field teams.

• Proficiency in Microsoft Office, CRM, AI, and relevant systems.

• Knowledge of access and reimbursement processes.

• Understanding of prior authorization workflows, healthcare reimbursement systems, coding and billing, and patient support programs.

• Knowledge of compliance and privacy requirements.

• Ability to respond swiftly to urgent access requirements.

• Capability to operate effectively in matrix field environments.

• Willingness to travel up to 50%, including occasional overnight and weekend obligations.

🏝️ Benefits

• 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 and bi-annual company-wide shutdowns.

• Flexible work models, including remote work arrangements where feasible.

• Career development opportunities.

• Financial plans with options to save for retirement or other goals.

• Emphasis on work/life balance.