Member Care Advocate

EmpiRx Health, LLC.; Orlando (FL); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Paid Time Off

401(k)

Health Insurance (Dental & Vision)

Health Savings Account

Employee Assistance Program

Job summary

EmpiRx Health, LLC is seeking a dedicated Member Care Advocate to provide proactive member support onsite in Orlando. This role focuses on case management, coordination with pharmacies and prescribers, and delivering concierge-level service to assigned members.

You will work under the supervision of a Clinical Account Executive, use population health tools, adhere to KPIs, and collaborate across departments to ensure timely, accurate care.

Qualifications

• Minimum 2 years of experience working for a PBM, health plan or call center of MTM program; or 4 years 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.
• Excellent time management skills with the ability to meet tight deadlines.
• Excellent verbal and written communication skills.

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 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.

Skills

Customer service

Time management

Verbal communication

Written communication

Education

National certification (NHA or PTCB)

Tools

Microsoft Office

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Member Care Advocate

Full Time Orlando, FL, US

3 days ago Requisition ID: 1289

Member Care Advocate (CPhT)

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:

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.

What You’ll Do:

As a Member Care Advocate, your role will encompass a wide range of responsibilities, which may include but are not limited to:

• 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.

Education and Experience:

• 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.

Licensure/Certifications

You must be NATIONALLY CERTIFIED through NHA or PTCB to be qualified.

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.