Capital Rx · 1 day ago
Account Manager, PBM
Rochester, NY
Full-time
Hybrid
Mid, Senior Level
$80K/yr - $100K/yr
5+ years expJudi Health is an enterprise health technology company that provides comprehensive solutions for employers and health plans. The Account Manager, PBM is responsible for managing client benefit requests and supporting the implementation of new plans, ensuring timely and accurate execution throughout the client lifecycle.
Hospital & Health Care
No H1B
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 validate coding accuracy
Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address
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 other data inputs into client management processes
Collaborate cross functionally to support general client operations, as required
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
Qualification
Required
Undergraduate bachelor's degree, with record of strong 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
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
Company
Capital Rx
Capital Rx is now Judi Health! Navigate to our new page here: https://www.linkedin.com/company/judi-health
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
A. J. Loiacono
CEO
Ryan Kelly
CTO
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