Job Description

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What you will do

Let's do this. Let's change the world. In this vital role you will provide logistical, non-medical educational assistance to patients and caregivers as well as office and site of care staff, including physicians, nurses, office managers and executives. The PAL works in a highly visible, strong team environment to provide exceptional customer service on all levels. Specifically, listen to patients, interpreting their specific needs and providing friendly, professional and well-informed answers to their non-medical, logistical questions. The PAL will work with the patient to educate on next steps required to gain access to therapy. The PAL will also work to maintain relationships with patients and families, and by extension physicians and their staff and cross-functional partners to support ongoing compliance with therapy. Strong knowledge and demonstrated history of access and reimbursement for buy and bill/infused pharmaceutical products is required. The PAL will work with numerous internal teams, including Market Access, Medical Affairs, Advocacy, Marketing, and Site of Care to facilitate and improve patient access to insurance, medications, financial support, resources and more.

Key Responsibilities

Secure written or electronic HIPAA consent to Amgen By Your Side for patients in the assigned geography
Develop relationships with patients and caregivers by engaging via phone, text, email, virtual or in person connections
Assess individual needs of the patient and develop an appropriate education and resource plan of action, considering the patient's family and team of healthcare providers to empower the patient to become their own advocate
Educate the patient on KRYSTEXXA coverage based on their benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Provide information on co-pay assistance programs, national foundations, and free drug programs by sharing information to patients as appropriate and needed
Provide proactive education to prescribers and sites of care upon patient enrollment on coverage for Amgen rare disease therapies, common prior authorization requirements, and coding and billings requirements
Provide access and reimbursement education based on the enrolled patient's KRYSTEXXA benefits to physician offices and sites of care
Educate the physician office and/or SOC on KRYSTEXXA coverage based on the patient's benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Investigate access challenges pre and post-infusion
Partner with Safety and PV and report AE's and product complaints through medical information.
Work closely with the Amgen cross functional team including Case Managers, the Site of Care team, market access, matrix partners and external vendors
Adhere to professional standards compliance guidance, policies and procedures, federal, state, and local requirements

Additional Qualifications/Responsibilities

Basic Qualifications - Level 5

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

Basic Qualifications - Level 6

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

Preferred Qualifications

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

Thrive

What you can expect of us

As we work to develop treatments that take care of others, we also work to care for our teammates' professional and personal growth and well-being.

The annual base salary range is from $158,394 -$193,988 for Level 5 , $164,276 - $ 222,256 for Level 6. Actual salary will vary based on several factors including, but not limited to, relevant skills, experience, and qualifications.