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Capital Rx Jobs in New York (NOW HIRING)

Capital Rx

Senior Forward Deployed Engineer

Manhattan, NY · On-site

$115K - $158K/yr

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 ...

Capital Rx

IT Manager

Manhattan, NY · On-site

$120K - $150K/yr

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 ...

Capital Rx

Data Scientist

Manhattan, NY · On-site

$96K - $121K/yr

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 ...

Capital Rx

Judi SaaS Sales, VP

Manhattan, NY · On-site

$218K - $273K/yr

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 ...

Capital Rx

Appeals Technician (temp-to-hire)

Manhattan, NY · On-site

$60K - $65K/yr

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 ...

Capital Rx

Full Stack Software Developer

Manhattan, NY · On-site

$108K - $136K/yr

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 ...

Capital Rx

Legal Counsel

Manhattan, NY · On-site

$115K - $182K/yr

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 ...

Capital Rx

Clinical Account Consultant, PBM

Manhattan, NY · On-site

$140K - $160K/yr

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 ...

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Capital Rx information

See New York salary details

$21.9K

$91.1K

$190.2K

How much do capital rx jobs pay per year?

As of Aug 10, 2026, the average yearly pay for capital rx in New York is $91,104.00, according to ZipRecruiter salary data. Most workers in this role earn between $43,184.00 and $121,899.00 per year, depending on experience, location, and employer.

What is the interview process for Capital Rx?

The interview process for a role at Capital Rx typically involves an initial phone screening followed by one or more in-person or virtual interviews. Candidates may be assessed on their technical skills, industry knowledge, and cultural fit, often including behavioral questions and skill assessments relevant to the position.

What kind of team environment can I expect working at Capital Rx?

At Capital Rx, you will typically be part of a highly collaborative and fast-paced team focused on improving healthcare outcomes through transparent pharmacy benefits. Teams often include pharmacy technicians, clinical pharmacists, data analysts, and client service specialists working closely to deliver high-quality solutions. Open communication, innovation, and cross-functional collaboration are encouraged, so you'll regularly interact with colleagues from different departments. This dynamic environment provides excellent opportunities to learn, contribute ideas, and advance your career as the company grows.

What are the key skills and qualifications needed to thrive in the Capital Rx position, and why are they important?

To excel in a role at Capital Rx, candidates generally need a solid background in pharmacy benefit management (PBM), healthcare analytics, or related fields, paired with a relevant degree. Familiarity with claims adjudication platforms, PBM software, and data analysis tools like SQL or Excel is highly valued. Strong problem-solving abilities, attention to detail, and effective communication are essential soft skills for success. These competencies enable professionals to manage complex pharmacy benefit operations efficiently, ensure regulatory compliance, and foster positive relationships with clients and team members.

What is a Capital Rx?

Capital Rx is a pharmacy benefit manager (PBM) that focuses on improving drug pricing transparency and patient outcomes. A job at Capital Rx typically involves roles in pharmacy operations, technology, client services, or healthcare strategy. Employees work to modernize the prescription drug payment system and enhance access to affordable medications. Positions may require expertise in healthcare, analytics, or customer relations, depending on the specific role.

What job categories do people searching Capital Rx jobs in New York look for? The top searched job categories for Capital Rx jobs in New York are:
What cities in New York are hiring for Capital Rx jobs? Cities in New York with the most Capital Rx job openings:
Capital Rx jobs near you
Infographic showing various Capital Rx job openings in New York as of August 2026, with employment types broken down into 88% Full Time, 8% Part Time, 1% Temporary, and 3% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $91,104 per year, or $43.8 per hour.

Manager, Medical Utilization and Care Management

Capital Rx

Manhattan, NY • On-site

$95K - $130K/yr

Other

This job post has expired today. Applications are no longer accepted.

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.

Position Responsibilities:

  • Provide oversight for vendors conducting utilization management, care management, and clinical operations activities.
  • Oversee vendor execution of utilization reviews, including prospective, concurrent, and retrospective reviews, to ensure medical necessity and appropriate level of care determinations.
  • Monitor vendor review of medical records and treatment plans to support appropriate service utilization, avoid unnecessary or duplicate services, and optimize reimbursement outcomes.
  • Partner with the Medical Director and vendor clinical leadership on complex cases, escalations, policy development, and clinical determinations.
  • Provide oversight of vendor-managed prior authorization, peer-to-peer review, denial, appeal, and notification processes.
  • Ensure vendors complete comprehensive biopsychosocial assessments and health risk assessments (HRAs) in accordance with program requirements.
  • Oversee vendor-led care coordination across the continuum, including transitions of care and discharge planning.
  • Provide oversight of vendor-administered chronic disease and complex case management programs.
  • Monitor vendor documentation practices to support risk adjustment, compliance, and continuity of care.
  • Review utilization trends and vendor performance data to identify quality improvement opportunities and ensure action plans are implemented.
  • Ensure vendor compliance with applicable regulatory and accreditation standards, including URAC and NCQA requirements.
  • Coordinate with vendor interdisciplinary teams, including nurses, social workers, and care coordinators, to promote aligned clinical operations and member outcomes.
  • Promote vendor-delivered care coordination aligned with nursing practice principles and measurable quality, cost, and member experience outcomes.

Required Qualifications:

  • Active unrestricted RN license (BSN preferred)
  • 5+ years of experience in utilization management, care management, or case management
  • 2+ years leadership experience
  • Knowledge of medical necessity reviews, care coordination models, and payer systems

Preferred Qualifications:

  • Certification (CCM, CMGT-BC, HCQM).
  • Experience with Commercial, Medicare and Medicaid population.
  • Experience working with Medical Directors, Vendors, and Health Systems.
  • Knowledge of URAC/NCQA standards.
New York, NY Salary Range
$95,000—$130,000 USD
Denver, CO Salary Range
$95,000—$130,000 USD
Charlotte, NC Salary Range
$95,000—$130,000 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.

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