Patient Access Liaison, Manager – Rare Disease

Role Overview

• 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 to 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

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
• 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

Benefits

• A 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
• A discretionary annual bonus program
• Stock-based long-term incentives
• Award-winning time-off plans
• Flexible work models where possible