Lead Population Health Pharmacy Strategy

EmpiRx Health; Montvale (NJ); Hybrid; USD 125,000 - 155,000; Full time

Benefits offered by this job

Paid Time Off

a 401(k) program

Health Insurance including Dental &amp

Vision coverage

Health Savings Account

Employee Assistance Program.

Student Loan Reimbursement

Job summary

EmpiRx Health in Montvale, NJ is seeking a Population Health Clinical Executive to lead clinical interventions within the Care Management department. You will monitor RXCurve tickets, review high-cost cases, engage physicians, and document savings opportunities to support our value-based model.

The role collaborates with CAEs, Prior Authorization, CPTs, Analytics, and others to drive outcomes, maintain compliance, and ensure timely clinical determinations.

Qualifications

• 3+ years of experience in PBM, healthcare operations, clinical case management, or similar roles.
• Experience with clinical interventions, formulary management, or healthcare reporting.
• Active Pharmacist License in good standing.

Responsibilities

• RXCurve 360 Ticket Management, High-Cost Case Reviews & Intervention Execution.
• Review High-Cost case tickets and ensure timely completion of reviews.
• Document clinical interventions and savings opportunities for reporting.
• Assist with clinical prior authorization and appeals reviews as needed.
• Collaborate with Population Health Manager and cross-functional teams to improve outcomes.

Skills

Attention to detail

Organizational skills

Multitasking

Clinical judgment

Microsoft Excel

PowerPoint

Verbal and written communication

Analytical mindset

Team-oriented

Education

PharmD

Tools

RXCurve

Microsoft Excel

Microsoft Word

PowerPoint

Job description

EmpiRx Health in Montvale, NJ is seeking a Population Health Clinical Executive to lead clinical interventions within the Care Management department. You will monitor RXCurve tickets, review high-cost cases, engage physicians, and document savings opportunities to support our value-based model.

The role collaborates with CAEs, Prior Authorization, CPTs, Analytics, and others to drive outcomes, maintain compliance, and ensure timely clinical determinations.