Capital Rx · 2 days ago

Customer Success Manager - Benefits Administration

United States

Full-time

Remote

Mid Level

$90K/yr - $120K/yr

4+ years exp

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Responsibilities

Provide configuration services and support of Capital Rx’s Software as a Service (SaaS) customers for migration and ongoing use of JUDI.

Provide customers with subject matter expertise in JUDI’s capabilities, ensuring successful migration to the adjudication platform, with parity of all plan benefit logic and initiatives.

Accountable for accurate translation of requirements/setup of plan benefits from previous adjudication systems and configure to the customer’s intent.

Build and maintain trusting relationships with customers through superior customer service, meeting or exceeded service level metrics.

Lead communications throughout the implementation period by providing detailed and strategic guidance on plan benefit configuration, including intersection points with network, formulary, clinical and data exchanges.

Proactively identify execution risks that would inhibit successful launch in JUDI or negatively impact member experience and propose mitigation strategies.

Identify and make recommendations drive configuration efficiencies for SaaS customers in JUDI.

Conduct comprehensive testing and review of plan benefit configurations using JUDIs Testing Module.

Monitor live claims for accuracy.

Responsible for ongoing customer support for set up for configuration evaluations and troubleshooting inquiries, working directly with customers, vendors, and operations teams to achieve positive outcomes, within the required turnaround times to meet service level agreements.

Take charge of critical issues or problems to key stakeholders, ensuring swift resolution and communication.

Create and maintain documentation (including but not limited to, P&Ps, SOPs, user guides and training materials) to support plan benefit configurations in JUDI.

Provide user training to SaaS customers as needed.

Provide virtual and in person product demonstrations, with the ability to sell product differentiators and resonate with current operational challenges.

Certain times of year may require meeting participation, travel, service support or other requirements outside of standard business hours, including weekends.

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

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

PBM experienceHealth plan experiencePlan configurationNetwork configurationPricing configurationClinical configurationMedicare Part D knowledgeClaims adjudication systemsProject managementExecution of deliverablesMicrosoft OfficeJiraMiroConfluenceGithubAWS RedshiftProblem-solvingHard-workingTime managementPrioritizationOrganizational skillsVerbal communicationWritten communicationInterpersonal skillsPresentation skillsAdaptabilityTeamworkSQLManaging large data setsPBM