Case Manager - Rare Disease - BKEMV- West Coast Remote

Amgen; Los Angeles (CA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health benefits

Retirement plan

Stock-based incentives

Paid time off

Remote work options

Job summary

Amgen in Los Angeles is seeking a Case Manager to oversee patient access, insurance approvals, and reimbursement workflows. You will coordinate with RBMs, PALs, MSLs, the hub, pharmacy, and providers to facilitate access to therapy and resolve barriers.

Responsibilities include maintaining case histories, tracking status, triaging denials, guiding patients through financial assistance programs, and reporting trends weekly. Strong communication and HIPAA familiarity are essential.

Qualifications

• Master’s degree OR Bachelor’s degree with 2 years of Case Management experience OR Associate’s degree with 6 years of Case Management experience OR High school diploma / GED with 8 years of Case Management experience.
• Excellent communication skills and commitment to customer service
• Ability to effectively resolve hurdles across multiple cases and geographies and time zones

Responsibilities

• Interact with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaisons (MSLs) to communicate insurance approvals and reauthorizations.
• Case manage steps to gain access to therapy with patients and families.
• Collaborate with Safety and PV to report Adverse Events and product complaints as needed.
• Maintain comprehensive case histories across US patients with notes from hub, pharmacy, insurers and providers.
• Track patient status for reimbursement and shipping; document weekly changes and trends.
• Triage and resolve reimbursement issues (PAs, denials, appeals, etc.) and liaise with medical offices for authorizations.

Skills

Excellent communication

Education

Master’s degree

Bachelor’s degree + 2 years Case Management

Associate’s degree + 6 years Case Management

High school diploma / GED + 8 years Case Management

Tools

Excel

PowerPoint

Job description

HOW MIGHT YOU DEFY IMAGINATION? You’ve worked hard to become the professional you are today and are now ready to take the next step in your career. How will you put your skills, experience and passion to work toward your goals? At Amgen, our shared mission—to serve patients—drives all that we do. It is key to our becoming one of the world’s leading biotechnology companies, reaching over 10 million patients worldwide. Come do your best work alongside other innovative, driven professionals in this meaningful role.

Live

What You Will Do

Let’s do this. Let’s change the world. In this vital role the Case Manager will experience day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs

• Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaison’s (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations
• Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy
• Partner with Safety and Pharmacovigilance (PV). Report Adverse Event (AE)’s and product complaints through medical information
• Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families
• Maintain and update patient status to track reimbursement and shipping status of U.S. patients
• Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems)
• Liaise with medical offices as necessary to obtain insurance authorizations
• Counsel patients and family on insurance and reimbursement options
• Identify general and specific adherence trends and suggest appropriate action
• Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks
• Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance
• Advise patients and families on insurance, financial assistance and therapeutic access programs
• Attend patient meetings, industry conferences and sales meetings

Win

What We Expect Of You

We are all different, yet we all use our unique contributions to serve patients. The professional we seek is a [type of person] with these qualifications.

Basic Qualifications:

• Master’s degree OR
• Bachelor’s degree and 2 years of Case Management experience Or
• Associate’s degree and 6 years of Case Management experience Or
• High school diploma / GED and 8 years of Case Management experience

Preferred Qualifications

• Bachelor’s Degree strongly preferred
• 5+ years of experience in the pharmaceutical industry
• 2+ years prior experience as a Case Manager
• Excellent communication skills and commitment to customer service
• Ability to effectively resolve hurdles across multiple cases at the same time
• Ability to learn product and disease information, familiarity with HIPAA and FDA
• Ability to manage communication with case managers and sales reps across multiple geographies and time zones
• Excel and PowerPoint skills required
• Up to 20% travel required

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.

In addition to the base salary, Amgen offers a Total Rewards Plan comprising 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 including:

• 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 and bi-annual company‑wide shutdowns
• Flexible work models, including remote work arrangements, where possible

Amgen is an Equal Opportunity employer and will consider you without regard to your race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.