Member Care Advocate (Montvale, NJ)
EmpiRx Health 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™, 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.
Position Summary:
The Member Care Advocate plays a critical role in delivering high-quality, concierge-level service to EmpiRx Health members by providing administrative oversight and case management support. This role ensures timely resolution of member inquiries, escalations, and coordination between members, pharmacies, and prescribers. The position supports population health initiatives through proactive engagement and adherence to defined KPIs and service standards. By collaborating cross-functionally, the Member Care Advocate contributes to improved health outcomes, member satisfaction, and operational excellence.
What You’ll Do:
Key Responsibilities:
Operations:
Manage assigned member cases using the population health management system, ensuring timely completion and accuracyServe as a liaison between members, pharmacies, and prescribers to coordinate care and resolve issuesRespond to member inquiries and requests in a professional and timely mannerHandle email communications and administrative tasks aligned with service expectationsSupport concierge-level services and assist with member-focused projects under pharmacist supervision
Member Experience & Service Delivery:
Provide high-quality, consistent, and empathetic support to membersResolve member escalations efficiently within defined turnaround timesEnsure adherence to KPIs related to call handling, case resolution, and service qualityDeliver best-in-class member experience through attention to detail and responsiveness
Compliance & Collaboration:
Follow all applicable laws, regulations, and internal processesCollaborate with Clinical Account Executives and Client Management teams on member-related needsCommunicate effectively across internal departments to ensure coordinated care delivery
Maintain documentation accuracy and compliance within systems and workflows
What You Need:
Education & Experience (Mandatory):
- Pharmacy Technician Certification (CPhT)
- Minimum 2 years of experience in PBM, health plan, or MTM call center environment OR 4 years in hospital/retail pharmacy setting
- Strong proficiency in Microsoft Office Suite
- Excellent verbal and written communication skills
- Strong time management and ability to work in a fast-paced environment
- Customer service orientation with a focus on delivering high-quality member experience
- Ability to work onsite 5 days per week
Experience (Preferred):
- Bachelor’s degree
- Active Pharmacy Technician license
- Experience working with population health or case management systems
- Prior experience supporting clinical or pharmacy operations teams
Benefits And Perks
Subject to program eligibility, this position qualifies for a robust suite of benefits including: Paid Time Off, a 401(k) program, Health Insurance including Dental & Vision coverage, Health Savings Account, and an Employee Assistance Program.
EmpiRx Health is an Equal Opportunity Employer
At EmpiRx Health, we wholeheartedly embrace the power of diversity and the magic of inclusion. The kaleidoscope of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're on a mission to build a team as diverse as the world we serve, where everyone is welcome and celebrated. We're not just breaking down barriers; we're actively erasing them to create an environment where opportunity knows no bounds. In unity, we find our strength and invite individuals from all walks of life to join us in our exhilarating journey to shape a brighter, more inclusive future together.
Note: This job description is a general outline of responsibilities and qualifications for the role. Additional duties may be assigned, and the position may evolve to meet the organization's needs.
