Account Manager, PBA

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit

Location : Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)

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-all while driving impactful solutions that directly shape business success. You'll lead key quality assurance initiatives, proactively identify claim discrepancies, and collaborate across teams to streamline processes, making a tangible impact on client satisfaction and operational efficiency. Your expertise will be essential in shaping client strategies, resolving complex issues, and upholding the values that keep Capital Rx ahead of the competition.

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 implementationas a critical member of theclient management teams with all day-to-day client requirements

• Responsible fortimelyandaccuratemanagement and execution of all client benefit requests, including benefit changes, eligibility changes,override requests,demosand 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 tovalidatecoding accuracy

• Lead claim reviews to proactivelyidentifydiscrepancies 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, asrequired

• Responsible for relationship management and contribution to successful NPS and Account Management Survey results, along with retention support

Qualifications:

• Undergraduate bachelor's degree, with record of strong academic performance

• 5+ years of proven experience in PBM / health plan, benefits consulting, healthcare

• Track recordof building trusting internal and external relationships

• Track recordof 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 deliveringhigh qualitywork product

New York, NY Salary Range $100,400—$125,500 USD Denver, CO Salary Range $92,000—$115,000 USD Charlotte, NC Salary Range $83,600—$104,500 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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.

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