Judi Health
Healthcare
AccountManager,PBM
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“Account Manager, PBM at Judi Health. Skills: Account Management, PBM, Health Technology, Client Relationship Management. 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”
What You'll Achieve.
contribution to successful NPS and Account Management Survey results; retention support
Industry & Context.
develop solutions to address discrepancies or inaccuracies
Travel requirements not to exceed 25%
What They're Looking For.
Must Have
Undergraduate bachelor’s degree, with record of 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, 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, Candidates must have authorization to work in the US at the time of application and throughout employment.
Nice to Have
SQL a bonus
What You'll Do.
timely and accurate management and execution of all client benefit requests
including benefit changes
and new implementations
Support implementation of new plans
consistent with strategic or administrative intent
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
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
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
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
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.
How You'll Work.
Team & Collaboration
Partner with clinical account manager (CAM) and account executive (AE) to manage clients; work with internal and external teams to complete required plan documentation; Collaborate cross functionally to support general client operations, as required
Communication Scope
Exceptional written and verbal communication skills
Process & Methodology
Ability to balance multiple complex projects simultaneously
Full Job Description
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, 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: Remote (For Non-Local) or 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 vali
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