Patient Access Liaison - UPLIZNA - (Rare Disease) Los Angeles/San Diego
Amgen
Summary
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.
Job description
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 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
- Doctorate degree and 2 years of patient services, and/or access and reimbursement, experience OR Master's degree and 4 years of patient services, and/or access and reimbursement, experience OR Bachelor's degree and 6 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
- Health Insurance
- Dental Insurance
- Vision Insurance
- Retirement and Savings Plan
- Life Insurance
- Disability Insurance
- Flexible Spending Accounts
- Discretionary Annual Bonus
- Stock-based Long-term Incentives
- Paid Time Off
- Flexible Work Models
Company overview
Amgen Inc. is a leading American multinational biopharmaceutical company headquartered in Thousand Oaks, California, founded in 1980. As one of the world's largest independent biotechnology companies, Amgen specializes in discovering, developing, manufacturing, and delivering innovative human therapeutics. The company focuses on six key therapeutic areas: inflammation, oncology/hematology, bone health, cardiovascular disease, nephrology, and neuroscience. Amgen's portfolio includes blockbuster drugs such as Enbrel for autoimmune diseases, Prolia and XGEVA for osteoporosis, Repatha for cholesterol management, Otezla for psoriasis, and Neulasta for chemotherapy-induced neutropenia. With approximately 28,000 employees worldwide, Amgen operates as a component of both the Dow Jones Industrial Average and Nasdaq-100 indices. The company maintains a robust research and development pipeline with numerous clinical programs across various stages, leveraging cutting-edge biotechnology and human genetic data to address some of the world's most challenging diseases. Amgen's manufacturing capabilities span multiple global locations, and it distributes products through pharmaceutical wholesale distributors and direct-to-consumer channels.