Customer Success Manager

About Capital Rx

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare 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 benefits and rebuilding trust in healthcare.

Position Summary:

As a member of the Enterprise Solutions team, you will pay a critical role in contributing to the success of Capital Rx’s customers leveraging JUDI, our Enterprise Health Platform, to service their own pharmacy administrative needs. The Enterprise Solution team seeks individuals who are passionate to change the landscape of claims processing while providing superior service. The expectations for growth in this role are to push beyond the core subject matter areas of expertise and serve as an expert across all domains of JUDI.

Position Responsibilities:

• Serve as the point of contact for all adjudication related inquires in support of Capital Rx’s Software as a Service (SaaS) customers.
• Provide configuration services and support as needed across multiple modules in JUDI.
• Provide customers with subject matter expertise in JUDI’s capabilities, ensuring successful migration to the adjudication platform.
• Accountable for accurate translation of requirements from previous adjudication systems and configure to the customer’s intent.
• Build and maintain trusting relationships with customers through superior customer service, meeting or exceeded service level metrics.
• Lead communications throughout the implementation period by providing detailed and strategic guidance on the intersection points of plan benefit configuration, network, formulary, clinical and data exchanges.
• Proactively identify execution risks that would inhibit successful launch in JUDI or negatively impact member experience and propose mitigation strategies.
• Identify and make recommendations drive configuration efficiencies for SaaS customers in JUDI.
• Conduct comprehensive testing and review of configurations.
• Monitor live claims for accuracy. Proactivly identify trends and claims discrepancies.
• Responsible for ongoing customer support for configuration evaluations, troubleshooting inquiries, working directly with customers, vendors, and operations teams to achieve positive outcomes, within the required turnaround times to meet service level agreements.
• Take charge of critical issues or problems to key stakeholders, ensuring swift resolution and communication.
• Certain times of year may require meeting participation, travel, service support or other requirements outside of standard business hours, including weekends.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. 

Minimum Qualifications:

• Bachelors Degree in relevant field or 4+ years experience in PBM or Health plan required
• 2+ years in a customer facing role
• Medicare Part D subject matter expertise required
• Experience operating multiple claims adjudication systems
• 1+ years of SQL experience and managing large data sets preferred
• PBM and/or pharmacy technician experience preferred
• Exceptional project / time management, prioritization, and organizational skills to ensure customer satisfaction
• Ability to shift between competing priorities and meet organizational goals
• Proficient in Microsoft office Suite and willing to adapt to software such as Jira, Miro, Confluence, Github, and AWS Redshift
• Excellent verbal, written, interpersonal and presentation skills
• Ability to work effectively with virtual teams
• Ability to travel 5-10%

Salary Range$90,000—$115,000 USD

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.

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.