PDL
PDL (which stands for Prescription Drug List) is a key tool used in pharmacy management that shows which medications are covered by insurance plans. Think of it as a catalog that pharmacists and healthcare providers use to know which medicines are approved for coverage, how much they cost, and what alternatives might be available. This list helps determine what patients will pay for their prescriptions and guides healthcare providers in choosing the most cost-effective treatment options. You might also see it called a "formulary" or "drug formulary" in job descriptions.
Examples in Resumes
Managed and updated PDL compliance for retail pharmacy chain
Conducted monthly PDL reviews to ensure insurance coverage accuracy
Trained staff on proper PDL interpretation and insurance billing procedures
Typical job title: "Pharmacy Benefits Managers"
Also try searching for:
Where to Find Pharmacy Benefits Managers
Professional Organizations
Job Boards
Professional Networks
Example Interview Questions
Senior Level Questions
Q: How would you handle a situation where a major insurance provider makes sudden changes to their PDL that affects thousands of patients?
Expected Answer: Should discuss creating action plans for patient communication, staff training, identifying alternative medications, coordinating with healthcare providers, and implementing systematic updates to pharmacy systems.
Q: Describe your experience in developing PDL policies and procedures.
Expected Answer: Should explain experience with creating guidelines for staff, ensuring compliance with regulations, coordinating with insurance companies, and managing updates to drug lists while considering both patient care and cost effectiveness.
Mid Level Questions
Q: How do you stay current with PDL changes and communicate them to staff?
Expected Answer: Should mention regular review of insurance updates, creating clear documentation, conducting staff training sessions, and maintaining open communication with insurance providers.
Q: What steps do you take when a prescription isn't on the PDL?
Expected Answer: Should discuss checking for alternatives, understanding prior authorization processes, communicating with prescribers, and explaining options to patients.
Junior Level Questions
Q: What is a PDL and why is it important?
Expected Answer: Should be able to explain that PDL is a list of covered medications, its role in insurance coverage, and how it affects patient costs and medication access.
Q: How do you verify if a medication is on a patient's PDL?
Expected Answer: Should demonstrate knowledge of using pharmacy software systems, checking insurance portals, and basic procedures for verifying medication coverage.
Experience Level Indicators
Junior (0-2 years)
- Basic PDL lookup and verification
- Insurance billing procedures
- Customer service skills
- Basic pharmacy software usage
Mid (2-5 years)
- PDL analysis and interpretation
- Prior authorization processing
- Staff training on PDL updates
- Insurance company coordination
Senior (5+ years)
- PDL policy development
- Formulary management
- Team leadership
- Strategic planning for PDL changes
Red Flags to Watch For
- Unfamiliar with basic insurance terminology
- No experience with pharmacy management systems
- Poor understanding of medication classes
- Lack of attention to detail in insurance verification
- No knowledge of healthcare compliance regulations
