• Job Description

  Req#: 2474744

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

  About Capital Rx

  Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

  Position Responsibilities:

  • Support implementation and client management teams with all day-to-day client requirements
  • Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations
  • Analyze incoming client requests and work with internal and external teams to complete required plan documentation
  • Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent
  • Lead pre- and post-implementation quality assurance and testing to validate coding accuracy
  • Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address
  • Handle and resolve sponsor and member issues, escalating as needed
  • Research and respond to claims processing and system configuration inquiries
  • Coordinate integration of other data inputs into client management processes
  • Collaborate cross functionally to support general client operations, as required

  
  Required Qualifications:

  • Undergraduate bachelor’s degree, with record of strong academic performance or equivalent job experience
  • 1+ years of proven experience in PBM / health plan, 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

  Base Salary: $60,000 - $80,000

  This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

  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.

• About the company

  On a mission to change the way prescription benefits are priced and administered in the US and rebuild trust in our healthcare system.

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