Account Manager, PBM

Judi Health•Denver, CO

1d•Hybrid

About The Position

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.

Requirements

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
Candidates must have authorization to work in the US at the time of application and throughout employment.

Nice To Haves

SQL a bonus

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
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.