Account Manager, PBA

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, Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Location Remote or Hybrid (Local to NYC or Denver area). Account Manager – PBA & Medicare As an Account Manager focused on PBA and Medicare, you’ll be at the forefront of delivering seamless client experiences by managing benefit changes, implementing new plans, and ensuring pricing accuracy. You’ll lead key quality assurance initiatives, proactively identify claim discrepancies, collaborate across teams to streamline processes, and shape client strategies to resolve complex issues. 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. 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. Maintain relationship management and contribute to successful NPS and Account Management Survey results, with retention support. Adhere to the Capital Rx Code of Conduct, including reporting of noncompliance. Qualifications / Profile Undergraduate bachelor’s degree, with a 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 knowledge is 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 and commitment to delivering high‑quality work product. Salary & Benefits Remote, US Salary Range: $80,000—$100,000 USD. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Capital Rx