Director, Clinical Solutions Success — Medicaid Formulary Strategy

Capital Rx Inc.; Charlotte (NC); On-site; USD 121,000 - 151,000; Full time

Job summary

Judi Health is seeking a Director, Clinical Solutions Customer Success to lead strategic clinical initiatives for the JUDI platform. You will design, implement, and optimize formularies, utilization management programs, and clinical benefit strategies while ensuring regulatory compliance and superior customer satisfaction.

The ideal candidate brings deep Medicaid Fee-For-Service pharmacy experience, strong leadership, cross-functional collaboration, and the ability to mentor teams while guiding

Qualifications

• Pharmacist license active and unencumbered.
• PharmD or Bachelor in Pharmacy required.
• 15+ years of pharmacy benefit and Medicaid experience.
• 5+ years leading teams.
• Experience with state Medicaid agencies and regulatory stakeholders.
• Formulary management and utilization management expertise.
• Experience with MMIS and CMS certification activities.
• PBM adjudication platform experience (RxClaim/JUDI).

Responsibilities

• Serve as the senior clinical lead for software licensing strategic customer relationships.
• Provide guidance on pharmacy benefit design, formularies, PDLs, and utilization management programs.
• Lead Judi Health team members and clients with implementation and migration activities.
• Advise on Prior Authorization, Step Therapy, Quantity Limits, and rebate programs.
• Support CMS certification, MMIS integrations, NCPDP standards, and regulatory compliance initiatives.
• Partner cross-functionally to resolve complex business and system challenges.
• Create and lead presentations and recommendations to customers and executive stakeholders.
• Identify operational risks and drive process improvements to enhance client outcomes.
• Develop documentation, training, and best practices for programs and teams.
• Mentor team members and provide leadership to individual contributors.

Skills

Leadership

Presentation skills

Relationship management

Cross-functional collaboration

Strategic thinking

Stakeholder management

Education

PharmD or Bachelor Degree in Pharmacy

Active, unrestricted Pharmacist license

Tools

RxClaim

JUDI

Job description

Judi Health is seeking a Director, Clinical Solutions Customer Success to lead strategic clinical initiatives for the JUDI platform. You will design, implement, and optimize formularies, utilization management programs, and clinical benefit strategies while ensuring regulatory compliance and superior customer satisfaction.

The ideal candidate brings deep Medicaid Fee-For-Service pharmacy experience, strong leadership, cross-functional collaboration, and the ability to mentor teams while guiding