Account Manager, PBA

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,
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), consolidating all claim administration-related workflows in one scalable, secure platform.

Location:

Hybrid – 3 days in office (NYC, Denver, CO, and Charlotte, NC areas)

Position Title:

Account Manager – PBA & Medicare

• Partner with Clinical Account Manager (CAM) and Account Executive (AE) to manage clients throughout implementation to renewal on a designated book of business.
• Support implementation as part of the client management team, handling day‑to‑day client requirements.
• Manage timely and accurate execution of all client benefit requests, including changes, eligibility updates, override requests, demos, and new implementations.
• Analyze incoming client requests with internal & external teams to complete required plan documentation.
• Support implementation of new plans, pricing, and networks, aligned 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.
• 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 additional data inputs into client management processes.
• Collaborate cross‑functionally to support general client operations as required.
• Maintain relationship management and contribute to successful NPS and Account Management Survey results, including retention support.
• Adhere to the Capital Rx Code of Conduct, including reporting non‑compliance.

• Undergraduate bachelor’s degree with strong academic performance.
• 5+ years of proven experience in PBM / health plan, benefits consulting, or healthcare.
• Track record of building trusting internal and external relationships.
• Track record of leading cross‑functional initiatives, driving high performance, meeting deadlines, and executing deliverables.
• Experience working with structured and unstructured data.
• Proficient in Microsoft Office; SQL is 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.

New York, NY: $100,400 – $125,500 USD

Denver, CO: $92,000 – $115,000 USD

Charlotte, NC: $83,600 – $104,500 USD

We provide equal employment opportunities to all employees and applicants 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.

All employees are responsible for adherence to the Capital Rx Code of Conduct, including the reporting of non‑compliance.