[Hiring] Patient Access Liaison @Amgen

Role Description

The Patient Access Liaison (PAL) 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 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 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.

Key Responsibilities

• Patient Access and Reimbursement Support
  • 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.
• Patient and Caregiver Engagement
  • 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.
• Provider and Site-of-Care Education
  • 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.
• Access Issue Resolution
  • 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.
• Cross-Functional Collaboration
  • 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.
• Compliance, Safety, and Operational Excellence
  • 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.

Qualifications

• 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

Requirements

• 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
• Travel up to 50%, including occasional overnight and weekend commitments

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 possible