VP, Health Plan & TPA Growth & Strategy

Judi Health, LLC

Colorado

Hybrid

USD 200,000 - 300,000

Full time

14 days+

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Job summary

Judi Health is seeking a strategic Vice President, Health Plan, Health System, & TPA Client Services to drive growth, retention, and client success across Health Plan, Health System, and TPA portfolios. You will partner with executive stakeholders and cross-functional teams to shape outcomes and ensure delivery of client priorities in a highly regulated environment.

The role requires deep healthcare domain expertise, executive presence, and a track record of managing complex, multi-faceted

Qualifications

Bachelor’s or advanced degree in health administration, business, or relevant professional experience.
10+ years of leadership experience within PBM, health plan, healthcare services, payer administration, or related environments.
Demonstrated success managing executive-level client relationships.
Experience leading complex accounts and multi-functional teams.
Experience supporting Regional Health Plans, Health Systems, TPAs, or payer organizations in highly regulated markets.
Strong understanding of the U.S. healthcare delivery system, payer operations, provider networks, government programs, and pharmacy benefit administration.
Strong understanding of PBM economics, rebate programs, formulary management, claims administration, and payer operations.
Experience partnering with Regulatory, Compliance, Government Programs, Underwriting, Supply Chain, Finance, Product, Operations, Clinical, Network, Technology, and Implementation teams to deliver client priorities.
Experience driving both revenue growth and client retention.
Strong executive presence and ability to influence stakeholders at all levels.

Responsibilities

Provide leadership support for Health Plan, Health System, and TPA relationships.
Develop and maintain senior-level client relationships.
Identify and advance growth, expansion, and retention opportunities.
Partner with Sales and Account Management on renewals and strategic opportunities.
Lead executive-level discussions regarding client strategy, performance, and long-term objectives.
Drive cross-functional accountability for client commitments and strategic initiatives.
Serve as an escalation point for complex operational, clinical, financial, and contractual issues.
Partner with Product, Operations, Clinical, Network, Finance, Regulatory, Compliance, Government Programs, and Implementation teams to execute client priorities, support delegated services and ensure successful delivery of client commitments.
Partner with Underwriting, Supply Chain, Finance, and Account Management to support ongoing contractual needs, case financial optimization, savings opportunities, and strategies that improve client outcomes while supporting organizational growth.
Collaborate across the organization to assess, design, and implement client-specific programs, benefit administration requirements, operational partnerships, and other customized solutions needed to support Health Plan, Health System, and TPA clients.
Partner with Regulatory, Compliance, Government Programs, and operational leaders to monitor and support highly regulated Health Plan markets, including State DOI and HHS/CMS requirements across Medicare, Medicaid, Exchange, insured, and FHBP business, as well as services delegated to Judi Health.
Assess organizational and client risks and develop mitigation strategies.
Coach and develop client-facing leaders and teams.
Support strategic planning and market-facing initiatives that strengthen Judi Health's position within the Health Plan, Health System, and TPA market.
FOR COMPLIANCE REASONS, MUST ADD: Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.