Job description

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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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 www.judi.health . Location : 3-days Hybrid (Local to NYC , Denver , or Charlotte ) Position Summary: The Account Manager, PBM is responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations. Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent. 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 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 Judi Health Code of Conduct, including reporting of noncompliance. Qualifications: 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 Visa Sponsorship: Judi Health does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment. 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. 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. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at judi.health .

Requirements

Must-haves

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 Judi Health Code of Conduct, including reporting of noncompliance.
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
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

Nice-to-haves

Proficient in Microsoft Office, SQL a bonus

Application prep

Use the role’s language and application details while tailoring your materials.

Keywords to mirror

aigosql

Platform: greenhouse
Effort: quick