Account Manager, PBA

1 month, 3 weeks ago
Full-time
Senior
Customer and Technical Support
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017

Description

  • Partner with the clinical account manager and account executive to manage clients from implementation through go-live and renewal.
  • Support implementation as a key member of the client management team and handle day-to-day client requirements.
  • Manage and execute client benefit requests, including benefit changes, eligibility changes, override requests, demos, and new implementations.
  • Analyze client requests and coordinate with internal and external teams to complete required plan documentation.
  • Support implementation of new plans, pricing, and networks aligned with strategic or administrative intent.
  • Lead pre- and post-implementation quality assurance and testing to validate coding accuracy.
  • Lead claim reviews to identify discrepancies or inaccuracies and develop corrective solutions.
  • Handle and resolve sponsor and member issues, escalating when needed.
  • Research and respond to claims processing and system configuration inquiries.
  • Coordinate integration of additional data inputs into client management processes and support cross-functional client operations.

Requirements

  • Bachelor’s degree with a strong academic record.
  • 5+ years of experience in PBM, health plan, benefits consulting, or healthcare.
  • Experience building trusting internal and external relationships.
  • Experience leading cross-functional initiatives, meeting deadlines, and executing deliverables.
  • Experience working with structured and unstructured data.
  • Proficiency in Microsoft Office; SQL is a plus.
  • Ability to manage multiple complex projects simultaneously.
  • Exceptional written and verbal communication skills.
  • High flexibility, strong organization, and the ability to shift priorities quickly.
  • Strong attention to detail and commitment to delivering high-quality work.
  • Ability to travel up to 25%.

Benefits

  • Remote or hybrid work option for candidates local to NYC or the Denver area.
  • Salary range of $80,000 to $100,000 USD.

Interested in this position?

Apply directly on the company website

Apply Now

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