Judi Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; Judi Health™, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and Judi®, the industry’s leading proprietary Enterprise Health Platform. To learn more, visit www.judi.health.

Support implementation and 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, 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.

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 adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Bachelor’s Degree preferred, or equivalent combination of education, training, and experience.

2+ years of proven experience in PBM / health plan, benefits consulting, or healthcare.

Health Plan experience required.

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.

Medicaid experience required.

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.

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.