Account Manager, PBM

Capital Rx; Denver (CO); Hybrid; USD 84,000 - 126,000; Full time

Job summary

Judi Health is seeking an Account Manager, PBM to expertly manage client benefit requests, changes, and implementations across New York, Denver, and Charlotte. You will collaborate with CAMs and AEs to guide clients from implementation through go-live and renewal, while ensuring accurate plan documentation and seamless network setups.

Ideal candidates have 5+ years in PBM/health plans, strong relationships, and demonstrated ability to lead cross-functional initiatives.

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

Responsibilities

• Partner with CAM and AE to manage clients through lifecycle from implementation to renewal.
• Support implementation as a critical member of client management teams with day-to-day requirements.
• Manage client benefit requests, eligibility changes, overrides, demos, and new implementations.
• Analyze client requests and coordinate with internal/external teams to complete plan documentation.
• Support implementation of new plans, pricing, and networks per strategic intent.
• Lead pre- and post-implementation QA and testing to validate coding accuracy.
• Lead claim reviews to identify discrepancies and develop solutions.
• Travel up to 25% of time.
• Handle sponsor and member issues, escalating as needed.
• Research and respond to claims processing and system configuration inquiries.
• Coordinate integration of data inputs into client processes.
• Collaborate across functions to support client operations.
• Contribute to NPS and account management survey results and retention efforts.
• Adhere to the Judi Health Code of Conduct, reporting noncompliance.

Skills

PBM/health plan experience

Relationship management

Cross-functional leadership

Communication skills

SQL (bonus)

Education

Bachelor's degree

Tools

SQL

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-daysHybrid (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 athttps://www.judi.health/legal/privacy-policy.