Director, Client Operations

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Responsibilities:

• Serve as a member of the client leadership team for major high-profile client opportunities and collaborate with the clinical account management team to develop client strategy roadmaps
• Support complex implementations and serve as a content expert for commercial opportunities
• Partner with the implementation team to support and inform the benefit and plan management builder in the adjudication platform
• Mentor and coach the client management teams and serve as a point of escalation on day-to-day client and member inquiries, execution of all client benefit requests, and implementation of new plans, pricing, and networks, consistent with strategic or administrative intent
• Ensure all client pre- and post-implementation quality assurance is conducted and tested to validate coding accuracy
• Ensure all claim reviews are conducted to proactively identify discrepancies or inaccuracies and develop solutions to address
• Collaborate cross functionally to support general client operations, as required
• Help build and develop job aids, policies and procedures, and standard operating procedures for the client operations management team
• Responsible for the adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• Undergraduate bachelor's degree, with record of strong academic performance
• 5+ years of proven experience in PBM, benefits consulting, healthcare
• Track record of building trusting internal and external relationships
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
• Experience working with structured and unstructured data
• Proficient in Microsoft Office, SQL a bonus
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high-quality work product

Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp, Capital Rx is executing its mission through the deployment of JUDI, the company's cloud-native enterprise health platform, and a Single-Ledger Model, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.

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