Foundation Support Advocate III

WellDyne; Lakeland (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

WellDyne is seeking a Foundation Support Advocate III to serve as a senior SME in a high‑volume environment, handling complex eligibility, benefit verifications, and PAPs. The role drives compliant medication distribution and high‑quality customer experiences while mentoring peers.

The ideal candidate has 3+ years in healthcare, robust Medicare knowledge, and a patient‑centric approach. The position supports training and process improvements in a dynamic office setting.

Qualifications

• Advanced expertise in Medicare benefits and complex program rules.
• Ability to interpret and resolve complex eligibility cases.
• Experience with manufacturer PAPs and specialty medications.
• Strong analytical and regulatory compliance skills.
• PHI/HIPAA compliance knowledge.
• Spanish bilingual is a bonus.

Responsibilities

• Serve as SME on program eligibility, benefit verification, and FPL calculations.
• Analyze and resolve highly complex benefit cases involving multiple payers.
• Lead complex specialty medication ordering with escalations or non‑standard solutions.
• Interpret client‑specific requirements and ensure regulatory reporting.
• Oversee product reshipment and compliant distribution.
• Mentor lower‑level staff and share process improvements.
• Support training, onboarding, or quality review activities.
• Handle sensitive issues with professionalism and empathy.

Skills

Medicare benefits

Benefit verifications

Complex eligibility

PAPs (patient assistance programs)

Regulatory compliance

HIPAA

Customer service

Spanish bilingual

Education

Certified Pharmacy Technician

High school diploma

Job description

At our company, we move fast, adapt quickly, and turn challenges into opportunities while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable.
Our Vision:
Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential.
Our Mission:
To be the disruptive force that drives meaningful change within pharmacy services.

Summary
The Foundation Support Advocate III serves as a senior contributor and subject‑matter expert within a high‑intensity environment. This position handles the most complex, sensitive, or escalated cases involving eligibility, benefits, specialty medications, and client‑specific requirements. FSA III demonstrates advanced judgment, functional leadership, and deep program expertise, while supporting peers through mentoring and guidance. They play a critical role in maintaining operational excellence, compliance, and high‑quality customer experiences amid demanding contact volume and complexity.

Essential Duties and 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 situations requiring escalations or non‑standard solutions.
• Interpret and implement highly 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 strict adherence to program rules governing medication distribution, prescription scheduling, authorized ordering personnel, and communication protocols.
• Act as a resource to lower‑level staff by providing guidance, informal mentoring, and process clarification.
• 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.

Education and Experience

• Preferred – Certified Pharmacy Technician, in good standing.
• High school diploma or equivalent.
• 3+ years of experience in patient assistance, healthcare, specialty pharmacy, or a related field.
• Demonstrated experience handling complex manufacturer PAPs.

Knowledge, Skills and Abilities

• Advanced expertise in Medicare benefits and the application of complex and 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 used to resolve 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.
• Demonstrated ability to deliver exceptional customer service and empathy in high‑pressure situations while serving as an informal resource or mentor to others.
• Follow HIPAA and PHI Compliance.
• Spanish Bilingual a bonus.

Work Environment / Physical Demands

This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand‑eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.

EOE M/F/D/V

– WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected status under federal, state, or local law.