TELECOMMUTE
Role details
Job location
Tech stack
Job description
Let's do this. Let's change the world. The Patient Access Liaison, Manager 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 Manager 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 Manager 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., 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 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, Master's degree and 2 years of patient services and/or access and reimbursement experience, Bachelor's degree and 4 years of patient services and/or access and reimbursement experience, Associate's degree and 8 years of patient services and/or access and reimbursement experience, 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
-
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 & conditions
The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $158,718 - $193,988. Actual salary will vary based on several factors including but not limited to, relevant skills, experience, and qualifications.
In addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include:
- 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, 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
- Flexible work models where possible. Refer to the Work Location Type in the job posting to see if this applies.