Member Care Advocate

EmpiRx Health, LLCMontvale, NJ
15dHybrid

About The Position

EmpiRx Health [https://www.empirxhealth.com/] is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-based pharmacy care, EmpiRx Health puts its customers and members first by enabling them to take control of their pharmacy benefits, healthcare outcomes, and financial results. We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health solution delivers tailored strategies for our clients. Leveraging our newly launched, AI-powered pharmacy care platform, Clinically [https://clinically.co/]™, EmpiRx Health’s pharmacists and client experience teams provide the highest quality pharmacy care to our clients and their members. This enables benefits plan sponsors to keep their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive growth trajectory in recent years. EmpiRx Health is experiencing unprecedented growth, and we are seeking a highly skilled and experienced Member Care Advocates. In this critical role, you will ensure proactive administrative oversight of all assigned members by utilizing EmpiRx Health’s population health management system for case management. You will also ensure escalations are reviewed and resolved within a timely manner to provide best-in-class service to assigned members. If you are a highly motivated Member Care Advocate with a strong background working in the PBM, health plan, or call center of medication therapy management (MTM) industries, and you are passionate about making a meaningful impact in the health care industry, we encourage you to apply.

Requirements

  • Pharmacy Technician certification (CPhT).
  • Minimum 2 years of experience working for a PBM, health plan or call center of medication therapy management (“MTM”) program; or 4 years of experience in a hospital or retail environment.
  • Availability to work 5 days per week onsite.
  • Proficient in Microsoft Office Suite.
  • Strong customer service orientation and commitment to delivering concierge-level service.
  • Ability to work in a fast-paced environment.
  • Ability to think critically and strategically.
  • Excellent time management skills with the ability to meet tight deadlines.
  • Excellent verbal and written communication skills.

Nice To Haves

  • 4-year college degree (preferred).
  • Pharmacy Technician license (preferred).

Responsibilities

  • Serve as an effective advocate for the client’s member population by providing high quality, thorough, and consistent service to identified members.
  • Serve as an effective administrative liaison between members, pharmacies, and/or prescribers.
  • Follow applicable laws, regulations, and defined internal processes to deliver exceptional service to EmpiRx members.
  • Complete assigned cases in the population health management system in a timely manner.
  • Administratively communicate with prescribers and members in accordance with EmpiRx Health’s call requirements to meet specific key performance indicator (“KPI”) standards.
  • Resolve member escalations in a courteous and professional manner, including following defined practices and within a targeted turnaround time.
  • Ensure that all email communications are attended to/handled in a timely and professional manner.
  • Respond to member inquiries/requests under the supervision of the assigned Clinical Account Executive.
  • Ensure that practices, processes, and procedures are continually followed to always deliver a best-in-class experience for members.
  • Assist with general projects that involve member concierge services under the direct supervision of a licensed pharmacist.
  • Effectively collaborate with EmpiRx Health internal departments to ensure members receive superior care that is professional, accurate, and timely.
  • Administratively respond to requests from Clinical Account Executives and the Client Management team (e.g., provider and pharmacy calls).
  • Effectively communicate and interact with all other EmpiRx Health departments, fostering teamwork and unity.
  • Perform other duties as assigned.

Benefits

  • Paid Time Off
  • a 401(k) program
  • Health Insurance including Dental & Vision coverage
  • Health Savings Account
  • Employee Assistance Program
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