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