Foundation Support Advocate III

WellDyne•Lakeland, FL

13d•Onsite

About The Position

The Foundation Support Advocate III is a senior contributor and subject-matter expert in a high-intensity environment. The role handles complex, sensitive, or escalated cases involving eligibility, benefits, specialty medications, and client-specific requirements. It requires advanced judgment, functional leadership, and in-depth program expertise, while supporting peers through mentoring and guidance. The position helps maintain operational excellence, compliance, and high-quality customer experiences amid demanding contact volume and case complexity. The role serves as an expert on program eligibility, benefit verification, Medicare-related programs, and Federal Poverty Level calculations; analyzes and resolves complex benefit and eligibility cases; supports complex specialty medication ordering; and interprets client-specific requirements for adverse events, product quality complaints, and regulatory reporting. It also guides compliant reshipment and replacement decisions, supports peers and training activities, identifies process improvements, and handles escalated customer issues with professionalism and empathy. The position is based in a typical office environment, requiring prolonged sitting at a computer and use of standard office and phone equipment. Occasional high stress may arise when dealing with customers or clients, and some travel may be required.

Requirements

High school diploma or equivalent.
At least 3 years of experience in patient assistance, healthcare, specialty pharmacy, or a related field.
Demonstrated experience handling complex manufacturer Patient Assistance Programs (PAPs).
Advanced expertise in Medicare benefits and complex or exception-based program requirements.
Expertise conducting, interpreting, and resolving complex benefit verifications involving multiple payers or programs.
Comprehensive knowledge of Medicare Extra Help and Medicare Savings Programs, including nuanced eligibility scenarios.
Advanced analytical and critical thinking skills for resolving highly complex, ambiguous, or escalated cases.
Strong understanding of pharmacy benefit designs, including cost-sharing structures, prior authorizations, and coverage limitations.
Deep knowledge of complex specialty medications, assessments, and regulatory requirements for handling and shipping high-cost therapies.
Thorough understanding of adverse event reporting and product quality complaint requirements, including client-specific and regulatory expectations.
Ability to deliver exceptional customer service and demonstrate empathy in high-pressure situations while serving as an informal resource or mentor.
Follow HIPAA and PHI compliance requirements.

Nice To Haves

Certified Pharmacy Technician, in good standing.
Spanish bilingual ability.

Responsibilities

Serve as a subject-matter expert on program eligibility, benefit verification, Medicare-related programs, and Federal Poverty Level (FPL) calculations.
Analyze and resolve highly complex benefit and eligibility cases involving multiple payers, programs, or exception scenarios.
Lead and support complex specialty medication ordering, including escalations or non-standard solutions.
Interpret and implement complex, client-specific requirements related to adverse events, product quality complaints, and regulatory reporting.
Oversee and guide product reshipment and replacement decisions to ensure compliance with contractual and regulatory standards.
Ensure adherence to program rules governing medication distribution, prescription scheduling, authorized ordering personnel, and communication protocols.
Provide guidance, informal mentoring, and process clarification to lower-level staff.
Identify process improvement opportunities related to intake, eligibility determination, and program execution.
Handle sensitive or escalated customer issues with advanced judgment, professionalism, and empathy.
Support training, onboarding, or quality review activities as assigned.
Perform additional duties as assigned.