Member Care Representative (CPhT)

EmpiRx Health, LLC.

Montvale (NJ)

On-site

USD 45,000 - 65,000

Full time

15 hours ago
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Job summary

EmpiRx Health, LLC. is seeking a Member Care Advocate to deliver concierge-level service to members, coordinating with pharmacies and prescribers, and supporting population health initiatives.

This role emphasizes timely resolution of inquiries, attention to KPI-driven service standards, and cross-functional collaboration to improve health outcomes. The position requires a CPhT, 2+ years in PBM/health plan call centers (or 4+ years in hospital/retail pharmacy), and strong Microsoft Office

Qualifications

  • Pharmacy Technician Certification (CPhT) is mandatory.
  • 2 years of PBM/health plan/MTM call center experience or 4 years in hospital/retail pharmacy.
  • Strong proficiency in Microsoft Office Suite.
  • Excellent verbal and written communication skills.
  • Strong time management in a fast-paced environment.
  • Onsite work in New Jersey: 5 days per week.

Responsibilities

  • Manage assigned member cases using population health management system with timely completion and accuracy.
  • Serve as liaison between members, pharmacies, and prescribers to coordinate care and resolve issues.
  • Respond to member inquiries and requests in a professional and timely manner.
  • Handle email communications and administrative tasks aligned with service expectations.
  • Support concierge-level services and assist with member-focused projects under pharmacist supervision.
  • Provide high-quality, consistent, and empathetic support to members.
  • Resolve member escalations efficiently within defined turnaround times.
  • Ensure adherence to KPIs related to call handling, case resolution, and service quality.
  • Deliver best-in-class member experience through attention to detail and responsiveness.
  • Follow all applicable laws, regulations, and internal processes.
  • Collaborate with Clinical Account Executives and Client Management teams on member-related needs.
  • Communicate effectively across internal departments to ensure coordinated care delivery.
  • Maintain documentation accuracy and compliance within systems and workflows.

Skills

Customer service
Verbal and written communication
Time management
Pharmacy knowledge

Education

Pharmacy Technician Certification (CPhT)

Tools

Microsoft Office Suite

Job description

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 accuracy
  • Serve as a liaison between members, pharmacies, and prescribers to coordinate care and resolve issues
  • Respond to member inquiries and requests in a professional and timely manner
  • Handle email communications and administrative tasks aligned with service expectations
  • Support concierge-level services and assist with member-focused projects under pharmacist supervision
Member Experience & Service Delivery:
  • Provide high-quality, consistent, and empathetic support to members
  • Resolve member escalations efficiently within defined turnaround times
  • Ensure adherence to KPIs related to call handling, case resolution, and service quality
  • Deliver best-in-class member experience through attention to detail and responsiveness
Compliance & Collaboration:
  • Follow all applicable laws, regulations, and internal processes
  • Collaborate with Clinical Account Executives and Client Management teams on member-related needs
  • Communicate 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):
  • Experience working with population health or case management systems
  • Prior experience supporting clinical or pharmacy operations teams
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