Patient Access Liaison - Krystexxa - Pittsburgh, PA

Role Summary

Patient Access Liaison in Pittsburgh, PA responsible for providing logistical, non-medical educational assistance to patients and caregivers, and for supporting access and reimbursement for Krystexxa. Builds relationships with patients, physicians, and site of care staff to educate on next steps required to gain access to therapy and to maintain ongoing adherence, working with cross-functional teams to facilitate insurance coverage and patient support.

Responsibilities

• Secure written or electronic patient HIPAA 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 to include support for denied claims and claim reviews
• 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

Qualifications

• Required: Doctorate degree AND 2 years of Sales/Account Management OR direct patient care experience OR
• Required: Master's degree AND 4 years of Sales/Account Management OR direct patient care experience OR
• Required: Bachelor's degree AND 6 years of Sales/Account Management OR direct patient care experience
• Preferred: Scientific background and ability to learn product and disease information
• Preferred: Nursing or other clinical background
• Preferred: Access and reimbursement for buy and bill products
• Preferred: Orphan or Rare disease experience
• Preferred: Familiarity with HIPAA guidelines and FDA requirements
• Preferred: Familiarity with and adherence to internal and OIG Compliance guidelines
• Preferred: Ability to handle difficult patient cases and resolve hurdles
• Preferred: Ability to work in a team environment and manage communication with case Liaisons and sales reps
• Preferred: Ability to respond immediately when necessary (within 24 hours) to prevent lapses in treatment
• Preferred: Strong analytical skills and ability to report on meaningful activity in the region
• Preferred: Proficient in Microsoft Office
• Preferred: Professional, proactive demeanor
• Preferred: Strong interpersonal skills and strategic mindset
• Preferred: Excellent written and verbal communication skills

Education

• Doctorate, or Master’s, or Bachelor's degree as a baseline qualification with relevant experience as noted above

Skills

• Access and reimbursement knowledge for infusion products
• Strong communication and relationship-building abilities
• Ability to educate patients, families, and healthcare professionals on coverage and authorization processes
• Proficiency in coordinating with multidisciplinary teams

Additional Requirements

• Potential for up to 50% travel, including some overnight and weekend commitments