Account Manager, PBA

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:Capital 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, andJudi , 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, visitwww.judi.health . Location: Remote or Hybrid (Local to NYC or Denver area)As an Account Manager focused on PBA and Medicare, you'll be at the forefront of delivering seamless client experiences by managing benefit changes, implementing new plans, and ensuring pricing accuracy-all while driving impactful solutions that directly shape business success. You'll lead key quality assurance initiatives, proactively identify claim discrepancies, and collaborate across teams to streamline processes, making a tangible impact on client satisfaction and operational efficiency. Your expertise will be essential in shaping client strategies, resolving complex issues, and upholding the values that keep Capital Rx ahead of the competition.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 businessSupport implementation as a critical member of the client management teams with all day-to-day client requirementsResponsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, override requests, demos and new implementationsAnalyze incoming client requests and work with internal and external teams to complete required plan documentationSupport implementation of new plans, pricing, and networks, consistent with strategic or administrative intentLead pre- and post-implementation quality assurance and testing to validate coding accuracyLead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to addressTravel requirements not to exceed 25%Handle and resolve sponsor and member issues, escalating as neededResearch and respond to claims processing and system configuration inquiriesCoordinate integration of other data inputs into client management processesCollaborate cross functionally to support general client operations, as requiredResponsible for relationship management and contribution to successful NPS and Account Management Survey results, along with retention supportResponsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.Qualifications / Profile:Undergraduate bachelor's degree, with record of strong academic performance5+ years of proven experience in PBM / health plan, benefits consulting, healthcareTrack record of building trusting internal and external relationshipsTrack record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverablesExperience working with structured and unstructured dataProficient in Microsoft Office, SQL a bonusAbility to balance multiple complex projects simultaneouslyExceptional written and verbal communication skillsExtremely flexible, highly organized, and able to shift priorities easilyAttention to detail & commitment to delivering high quality work productSalary Range$80,000—$100,000 USDAll employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found athttps://www.judi.health/legal/privacy-policy .