Develop and implement strategic plans to identify, engage, and close new clinical program ... or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program ...
Develop and implement strategic plans to identify, engage, and close new clinical program ... or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program ...
Develop and implement strategic plans to identify, engage, and close new clinical program ... or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program ...
Develop and implement strategic plans to identify, engage, and close new clinical program ... or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program ...
Pharmacy Benefits Program Director; Mount Sinai Health System; Full Time; Days
Manhattan, NY · On-site
$142K - $187K/yr
Responsible for ensuring downstream implementation processes are efficient and support the ... Facilitate meetings with PBM to resolve customer service issues and act as the escalated issue ...
Pharmacy Benefits Program Director; Mount Sinai Health System; Full Time; Days
Manhattan, NY · On-site
$142K - $187K/yr
Responsible for ensuring downstream implementation processes are efficient and support the ... Facilitate meetings with PBM to resolve customer service issues and act as the escalated issue ...
Senior Product Manager
$106K - $284K/yr
We're looking for aspiring analytical enthusiasts to drive efficiency and growth in Caremark's PBM ... Support engineering and data science teams to implement features by clarifying requirements ...
Posted today
Senior Product Manager
$106K - $284K/yr
We're looking for aspiring analytical enthusiasts to drive efficiency and growth in Caremark's PBM ... Support engineering and data science teams to implement features by clarifying requirements ...
Posted today
Senior Product Manager
New York, NY · On-site
$106K - $284K/yr
We're looking for aspiring analytical enthusiasts to drive efficiency and growth in Caremark's PBM ... Support engineering and data science teams to implement features by clarifying requirements ...
Senior Product Manager
New York, NY · On-site
$106K - $284K/yr
We're looking for aspiring analytical enthusiasts to drive efficiency and growth in Caremark's PBM ... Support engineering and data science teams to implement features by clarifying requirements ...
Product Management Senior Manager, Regulated Markets Solutions - Express Scripts - Hybrid
Morris Plains, NJ · On-site +1
$131K - $173K/yr
Interpret regulatory guidance and help ensure compliant implementation across teams and processes ... Knowledge of pharmacy adjudication processes and PBM operations. * Strong strategic thinking ...
Product Management Senior Manager, Regulated Markets Solutions - Express Scripts - Hybrid
Morris Plains, NJ · On-site +1
$131K - $173K/yr
Interpret regulatory guidance and help ensure compliant implementation across teams and processes ... Knowledge of pharmacy adjudication processes and PBM operations. * Strong strategic thinking ...
Senior Security Engineers - New York, NY - Onsite
Manhattan, NY · On-site
$126K - $172K/yr
You will work hands-on with engineering teams to map, implement, and validate technical security ... Own the lifecycle of vulnerability remediation by managing and maintaining Plans of Action and ...
Senior Security Engineers - New York, NY - Onsite
Manhattan, NY · On-site
$126K - $172K/yr
You will work hands-on with engineering teams to map, implement, and validate technical security ... Own the lifecycle of vulnerability remediation by managing and maintaining Plans of Action and ...
Support implementation and enhancement of compliance program elements, including policies and ... plan, PBM, TPA, or highly regulated business environments preferred. * Experience leading ...
Support implementation and enhancement of compliance program elements, including policies and ... plan, PBM, TPA, or highly regulated business environments preferred. * Experience leading ...
Sr. Manager, Pricing - Pharmacy Appeals
Manhattan, NY · On-site
$67.90 - $182.55/hr
In addition, you will be responsible for developing and implementing solutions individually and ... Prior PBM Knowledge. * Familiarity with wholesaler invoices. Education Bachelor's Degree or ...
Sr. Manager, Pricing - Pharmacy Appeals
Manhattan, NY · On-site
$67.90 - $182.55/hr
In addition, you will be responsible for developing and implementing solutions individually and ... Prior PBM Knowledge. * Familiarity with wholesaler invoices. Education Bachelor's Degree or ...
Program Manager - Prior Authorization Solutions
Parsippany, NJ · On-site
$65K - $95K/yr
Identifyand implement process improvements that enhance operational efficiency and scalability ... Direct experience with prior authorizations at a health plan, PBM, or UM organization * Experience ...
Quick apply
Program Manager - Prior Authorization Solutions
Parsippany, NJ · On-site
$65K - $95K/yr
Identifyand implement process improvements that enhance operational efficiency and scalability ... Direct experience with prior authorizations at a health plan, PBM, or UM organization * Experience ...
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
Director, Trade Client Relations
New York, NY · On-site +1
$155K - $175K/yr
... of PBM operations and understanding of drug and UM strategy and policy implementation * Has ... Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract ...
Director, Trade Client Relations
New York, NY · On-site +1
$155K - $175K/yr
... of PBM operations and understanding of drug and UM strategy and policy implementation * Has ... Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract ...
Associate Director, Clinical Client Services
Manhattan, NY · On-site
$129K - $150K/yr
Support implementation activities, disruption reviews, and post-go-live evaluations. * Identify ... Experience managing client-facing clinical teams within the PBM industry. * Experience supporting ...
Associate Director, Clinical Client Services
Manhattan, NY · On-site
$129K - $150K/yr
Support implementation activities, disruption reviews, and post-go-live evaluations. * Identify ... Experience managing client-facing clinical teams within the PBM industry. * Experience supporting ...
Account Manager, PBA
Manhattan, NY · On-site
$100K - $125K/yr
Support implementation of new plans, pricing, and networks, consistent with strategic or ... in PBM / health plan, benefits consulting, healthcare * Track recordof building trusting internal ...
Account Manager, PBA
Manhattan, NY · On-site
$100K - $125K/yr
Support implementation of new plans, pricing, and networks, consistent with strategic or ... in PBM / health plan, benefits consulting, healthcare * Track recordof building trusting internal ...
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
... implementations, and reducing the ongoing data backlog. * Reconcile and feed PG data into ... Experience in a PBM, healthcare, or healthtech environment. * Familiarity with performance ...
New
... manager, overseeing prescription benefit plans on behalf of employers, unions, and government ... Success in this role requires strong PBM data knowledge, advanced analytical skills, a proactive ...
... manager, overseeing prescription benefit plans on behalf of employers, unions, and government ... Success in this role requires strong PBM data knowledge, advanced analytical skills, a proactive ...
Client Experience Manager, Pharmacy Benefits Management
New York, NY · On-site
$46K - $122K/yr
Serve as a presence throughout the implementation process. * Facilitate and participate in external ... Required Qualifications * 5+ years of experience in a pharmacy, PBM ( Pharmacy Benefit Management ...
Client Experience Manager, Pharmacy Benefits Management
New York, NY · On-site
$46K - $122K/yr
Serve as a presence throughout the implementation process. * Facilitate and participate in external ... Required Qualifications * 5+ years of experience in a pharmacy, PBM ( Pharmacy Benefit Management ...
Data Exchange Analyst - Eligibility
Manhattan, NY · On-site
$96K - $121K/yr
Attend new client implementation meetings with external partners to discuss eligibility ... Ability to match key PBM concepts and data fields across various systems and file layouts to ensure ...
Data Exchange Analyst - Eligibility
Manhattan, NY · On-site
$96K - $121K/yr
Attend new client implementation meetings with external partners to discuss eligibility ... Ability to match key PBM concepts and data fields across various systems and file layouts to ensure ...
... implementation, service, operations, communications, and product resources * Ensure contract ... Required Qualifications: * 7+ years of experience in PBM account management, demonstrating a ...
... implementation, service, operations, communications, and product resources * Ensure contract ... Required Qualifications: * 7+ years of experience in PBM account management, demonstrating a ...
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Re-posted 4 days ago
Job description
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: Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)
Position Summary:
This individual will report to the Associate Director of Clinical Program Business Development and be responsible for supporting the sales and profitability of Capital Rx's suite of clinical programs. This role serves as a primary business development lead for clinical offerings, from opportunity identification, client presentations, to negotiations and contracting. This role will drive clinical programs sales to new and existing PBM clients and foster strategic relationships with consultant groups. The ideal candidate will combine clinical expertise with strategic sales acumen to expand program adoption and deliver measurable value to clients.
Position Responsibilities:
- Drive the sales strategy for Capital Rx's suite of clinical programs end-to-end from prospecting through close in the small market and union sectors, including labor unions, municipal groups, and small employer-sponsored health plans.
- Proactively assess client data to identify opportunities, meet with account teams to qualify opportunities, and deliver compelling presentations, proposals, and ROI analyses to prospects to drive clinical program sales.
- Develop and implement strategic plans to identify, engage, and close new clinical program opportunities to achieve revenue targets.
- Cultivate and manage trusted relationships with
- Maintain a strong understanding of market dynamics, competitive landscape, and client needs to inform sales strategy.
- Contribute to strategic client retention initiatives by aligning clinical programs with client goals.
- Demonstrate strong analytical, presentation, and CRM skills to support sales execution and tracking.
- Maintain a deep understanding of clinical programs, regulatory requirements (e.g., CMS, NCQA, URAC), and industry trends to effectively position our solutions.
- Serve as a liaison between the field and internal product/clinical teams to ensure offerings remain competitive and relevant.
- Support implementation handoffs to ensure smooth onboarding of new clients.
- Provide market feedback to inform future product development and innovation.
- Support general business needs and operations, as required.
- All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
Minimum Qualifications:
- Education: Bachelor's degree in Business, Healthcare Administration, or related field (MBA preferred)
- 7 years of total work experience. 5+ years of applicable experience in a health plan or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program, Managed Care Residency or Fellowship with additional 2+ years of applicable experience
- Exceptional negotiation, presentation, and communication skills with the ability to articulate clinical value propositions to diverse audiences.
- Experience engaging or partnering with pharmacy consultant firms
- Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy benefits
- Ability to analyze data and market trends to inform sales strategy and client recommendations.
- Proven track record of meeting or exceeding sales targets and successfully closing complex B2B deals.
- Maintain an active, unrestricted pharmacy license in the state of residence
- Ability to balance multiple complex projects simultaneously with minimal direction
- Ability to travel up to 50%
Preferred Qualifications:
- PharmD
- Experience working with HEDIS, Stars and PQA pharmacy quality measures
- Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
- Experience with Confluence, Jira, Tableau
- Highly detail-oriented and analytical
Visa Sponsorship: Capital Rx 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.
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.
About Capital Rx
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
New York, NY, US
Year founded
2017