Foundation Support Advocate III

WellDyne•Lakeland, FL

12d

About The Position

The Foundation Support Advocate III is a senior contributor and subject-matter expert who works in a high-intensity environment handling complex, sensitive, or escalated cases involving eligibility, benefits, specialty medications, and client-specific requirements. The role requires advanced judgment, functional leadership, and deep program expertise, while supporting peers through guidance and informal mentoring. It contributes to operational excellence, compliance, and high-quality customer experiences amid demanding contact volume and case complexity.

Requirements

High school diploma or equivalent.
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.
Expert ability to conduct, interpret, and resolve 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 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 provide exceptional customer service and 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 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 and non-standard solutions.
Interpret and implement 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 for 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.