Job Opportunities API

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx , a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™ , which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health . Location : 3-days Hybrid (Local to NYC ,  Denver , or Charlotte )   Position Summary: The Account Manager, PBM is responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations. Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent. Position Responsibilities: Partner with clinical account manager (CAM) and account executive (AE) to manage clients through the entire lifecycle from implementation through go-live and renewal on a designated book of business   Support implementation as a critical member of the client management teams with all day-to-day client requirements  Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, override requests, demos and new implementations  Analyze incoming client requests and work with internal and external teams to complete required plan documentation  Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent  Lead pre- and post-implementation quality assurance and testing to validate coding accuracy  Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address  Travel requirements not to exceed 25%  Handle and resolve sponsor and member issues, escalating as needed  Research and respond to claims processing and system configuration inquiries  Coordinate integration of other data inputs into client management processes  Collaborate cross functionally to support general client operations, as required  Responsible for relationship management and contribution to successful NPS and Account Management Survey results, along with retention support  Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.    Qualifications: Undergraduate bachelor’s degree, with record of strong academic performance  5+ years of proven experience in PBM / health plan, benefits consulting, healthcare  Track record of building trusting internal and external relationships  Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables  Experience working with structured and unstructured data  Proficient in Microsoft Office, SQL a bonus  Ability to balance multiple complex projects simultaneously  Exceptional written and verbal communication skills  Extremely flexible, highly organized, and able to shift priorities easily  Attention to detail & commitment to delivering high quality work product    Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must