Position Overview:

The Account Executive/Strategic Account Executive - PBA Services is responsible for managing the planning, execution, growth & retention and client satisfaction of assigned clients in the Pharmacy Benefit Administration (PBA) market segment including Health Plans, Third Party Administrators (TPAs), and other Platform services. Additionally, this position will lead and collaborate through the broader Account Management team and with internal Capital Rx teams/departments as the client voice and advocate to ensure ongoing client satisfaction and to achieve client priorities and contractual obligations.

This position acts as the quarterback and leader of the broader Account Management team who are aligned in support of our clients. This position reports to the Senior Account Executive/Senior Director, PBA Client Services.

Position Responsibilities:

• Work closely with some of our biggest Texas-based clients and manage the complexities of working within a highly-regulated market of the TDI (Texas Department of Insurance)

• Provide oversight and direction to the broader Account Management team with a focus on member and client satisfaction, trend management, client growth & retention, and regulatory compliance to meet client specific objectives, client priorities and service model deliverables

• Lead and develop the client relationship strategy and the strategic business planning process across the clients in your portfolio while incorporating other internal staff where and when needed to build and foster relationships with influencers and decision makers.

• Maintain thorough knowledge and tracking of contractual obligations on assigned book of business, including financials, performance guarantees, terms, and reporting/compliance

• Manage and facilitate the Account renewal and contracting process with a focus on client retention and the client financial/PNL management

• Serve as the relationship lead on assigned book of business, incorporating other internal staff where and when needed to the relationship; build and foster relationships with influencers and decision makers at the client

• Anticipates customer needs and proactively identifies new opportunities within assigned accounts.

• Develop and maintain comprehensive knowledge of our business, including products and services to field questions from the client side and to answer timely & accurately

• Collaborate with internal teams to customize offerings and solutions, aligning with Health Plan/TPA Account needs and market demands - assemble internal resources to overcomes challenges.

• Analyze and interpret current pharmacy and healthcare trends, competitor activities, and industry regulations to inform strategic decisions, provide proactive recommendations for plan management and enhance the company's positioning within the PBA Services segment

• Lead, coach and support the Account Team on the effective positioning of the Capital Rx value proposition, our suite of Capital Rx Products and Solutions and JUDI capabilities available to our PBA clients

• Partner with our Business Development, Underwriting Teams & Senior Account Executives to support our PBA Account level growth and retention efforts by providing with Capital Rx sales support and market differentiator positioning, including RFP support, Broker/Consultant engagement and Best & Final support for prospective, existing and new and client business development needs

• Provide ongoing direction, coordination and coaching to the broader Account Team to align the Account Team understanding of the assigned client(s) business lines, strategies, key stakeholders & decision makers and priorities

• Serve as the content expert for Health Plan/TPA clients & opportunities

• Identify and help contribute to process improvement efforts

• Be accountable & own the client end-to end, inclusive of service model deliverables, contractual negotiations, client escalations and PNL management.

• All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications:

• Bachelor’s or advanced degree in health administration, business, or relevant professional experience. Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution is a plus

• Relevant professional experience for at least five (5) years in pharmacy – working within a health plan, managed care, or pharmacy benefits management (PBM) focused on Health Plans and Payer Commercial (Insured, Self-Funded, Exchange) and Government Program (Medicare & Medicaid) business lines. Health plan industry experience highly preferred

• Market and operational knowledge of Medicare Part D, Medicaid and Health Exchange pharmacy is required along with experience in supporting highly regulated business lines

• Track record of building trust in internal and external relationships

• Solution-focused problem solving and client positioning skills

• Exceptional written and verbal communication skills

• Ability to work with and influence peers in a team effort; leading cross-functional initiatives, meeting deadlines, and executing on deliverables while building strong internal relationships

• A decisive individual with sound technical skills, analytical ability, good judgement, and strong operational focus and detail-oriented perspective

• Flexible, highly organized, and able to shift priorities easily and work independently to meet deadlines

• Ability to effectively work with peers in a team effort

• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and large data sets and other industry software programs

• Ability to travel and present to small and large groups; travel is estimated to be up to 25% and be variable by season and business cycle

Preferred Qualifications:

• Experience working with clients who are subject to TDI (Texas Department of Insurance) rules and regulations

#LI-BC1

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

About Capital Rx:

Capital Rx is a full-service pharmacy benefit manager (PBM) overseeing prescription benefit plans on behalf of employers, unions, and government entities in the commercial space and provides Pharmacy Benefit Administration (PBA) services to Health Plans and TPAs.  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. 

Position Overview:

The Account Executive/Strategic Account Executive - PBA Services is responsible for managing the planning, execution, growth & retention and client satisfaction of assigned clients in the Pharmacy Benefit Administration (PBA) market segment including Health Plans with multiple lines of businesses, Third Party Administrators (TPAs), commercial employer groups, and other Platform services.  Additionally, this position will lead and collaborate through the broader Account Management team and with internal Capital Rx teams/departments as the client voice and advocate to ensure ongoing client satisfaction, retention, and to achieve client priorities and contractual obligations.

This position acts as the quarterback and leader of the broader Account Management team who are aligned in support of our clients. This position reports to the Senior Director, PBA Client Services.

Position Responsibilities:

• Provide oversight and direction to the broader Account Management team with a focus on client satisfaction, trend management, client growth & retention, and regulatory compliance to meet client specific objectives, client priorities and service model deliverables
• Lead and develop the client relationship strategy and the strategic business planning process across the clients in your portfolio while incorporating other internal staff where and when needed to build and foster relationships with influencers and decision makers
• Maintain thorough knowledge and tracking of contractual obligations on assigned book of business, including financials, performance guarantees, terms, and reporting/compliance
• Manage and facilitate the Account renewal and contracting process with a focus on client retention and the client financial/PNL management
• Serve as the relationship lead on assigned book of business, incorporating other internal staff where and when needed to the relationship; build and foster relationships with influencers and decision makers at the client
• Anticipates customer needs and proactively identifies new opportunities within assigned accounts
• Develop and maintain comprehensive knowledge of our business, including products and services to field questions from the client side and to answer timely & accurately
• Collaborate with internal teams to customize offerings and solutions, aligning with Health Plan/TPA Account needs and market demands - assemble internal resources to overcomes challenges 
• Analyze and interpret current pharmacy and healthcare trends, competitor activities, and industry regulations to inform strategic decisions, provide proactive recommendations for plan management and enhance the company's positioning within the PBA Services segment
• Lead, coach and support the Account Team on the effective positioning of the Capital Rx value proposition, our suite of Capital Rx Products and Solutions and JUDI capabilities available to our PBA clients
• Partner with our Business Development & Underwriting Teams to support our PBA Account level growth and retention efforts by providing Capital Rx sales support and market differentiator positioning, including RFP support, Broker/Consultant engagement and Best & Final support for prospective, existing and new and client business development needs
• Provide ongoing direction, coordination and coaching to the broader Account Team to align the Account Team understanding of the assigned client(s) business lines, strategies, key stakeholders & decision makers and priorities
• Serve as the content expert for Health Plan/TPA clients & opportunities
• Identify and help contribute to process improvement efforts
• Be accountable & own the client end-to end, inclusive of service model deliverables, contractual negotiations, client escalations and PNL management.
• All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications:

• Bachelor’s or advanced degree in health administration, business, or relevant professional experience. Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution is a plus
• Relevant professional experience for at least five (5) years in pharmacy – working within a health plan, managed care, or pharmacy benefits management (PBM) focused on Health Plans and Payer Commercial (Insured, Self-Funded, Exchange) and Government Program (Medicare & Medicaid) business lines.  Health plan industry experience preferred
• Market and operational knowledge of Medicare Part D, Medicaid and Health Exchange pharmacy is a plus along with experience in supporting highly regulated business lines
• Track record of building trust in internal and external relationships
• Solution-focused problem solving and client positioning skills
• Exceptional written and verbal communication skills
• Ability to work with and influence peers in a team effort; leading cross-functional initiatives, meeting deadlines, and executing on deliverables while building strong internal relationships
• A decisive individual with sound leadership and technical skills, analytical ability, good judgement, and strong detail-oriented perspective
• Flexible, highly organized, and able to shift priorities easily and work independently to meet deadlines
• Ability to effectively work with peers in a team effort
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and large data sets and other industry software programs
• Ability to travel and present to small and large groups; travel is estimated to be up to 25% and be variable by season and business cycle.

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

Position Summary:

Join our mission to transform our nation's healthcare system as a Senior Full-stack Software Developer. In this role you will assist in leading projects from design to delivery. Partner with product managers and designers to define requirements during discovery and planning. Collaborate with developers to deliver those requirements on time as new features or improvements to existing functionality. 

Why You’ll Love Working Here 

• We have a remote-first culture.
• You will make a tangible impact on society. Your code will directly improve healthcare experiences for millions.
• We are a late-stage startup with stability. We have startup energy with a focus on delivery, but healthy processes with a strong financial outlook that provides a sense of security. 

Position Responsibilities

In this role, you’ll combine technical leadership with hands-on coding to build scalable, high-impact healthcare technology. You will: 

• Exercise leadership over features from design to delivery. 
• Be a partner to product, design, and quality assurance team members. 
• Become a subject matter expert on your team’s products. 
• Provide technical support to cross-functional team members and stakeholders. 
• Expand Judi, our web-based enterprise health platform, using Python, AWS services, React/Typescript, and other technologies. 
• Work in an Agile/Scrum environment. 
• Code of Conduct: Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. 

Preferred Qualifications

We’re looking for someone who brings a mix of technical expertise, problem-solving ability, and collaborative spirit: 

• 7+ years of job-related experience. 
• Desire to work at a health tech company. 
• Strong Python (Flask / SQLAlchemy) and React / Typescript experience. 
• Advanced PostgreSQL database knowledge (e.g., common table expressions, windowing functions, views, stored procedures, full-text or geospatial indexing). 
• Experience with infrastructure as code using AWS, Terraform, or similar technologies. 
• Experience writing unit and integration tests. 
• Git expertise and experience working in a mono repo. 
• Able to demonstrate agency, urgency, and ownership over delivering quality work. 
• Strong written and verbal communication skills. 
• Previous Pharmacy Benefits Manager (PBM) experience is a plus. 

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.

Location: Hybrid (Local to NYC area)

About the team

The Platform team at Capital Rx is made up of a set of passionate, motivated, and driven individuals who are not only experts in technologies but are great problems solvers and brings high energy and inspiration every day. The team always works a sense of ownership and urgency delivering highest quality of work ensuring seamless operations and fostering collaboration across the software engineering department. We own the architecture, framework & standards, infrastructure and CI/CD pipelines which development teams utilize to deliver code to Captial Rx’s Judi® platform. The team is also responsible for the production environment which requires knowledge with monitoring, alerting and on-call practices. The Platform team performs many functions whether that is tactical operations, providing general solutions for the enterprise or giving guidance or recommendations for individual product teams.

Position Summary:

We are a rapidly growing late-stage health tech company helping millions of lives through our innovative product Judi. We’re seeking a highly skilled and experienced Senior Platform Developer II to join our platform team. This pivotal role will be instrumental in building, scaling, and maintain the robust and secure infrastructure that powers our mission-critical platform.

You will be a force multiplier, enabling our development teams to deliver features faster and more reliably. You will champion infrastructure-as-code principles, contribute code to platform scalability, drive automation across the entire software development lifecycle, and ensure our platform meets the highest standards of scalability, performance, and security.

Position Responsibilities:

• Architect, implement, and maintain highly available, scalable, and secure platform & infrastructure
• Develop and maintain robust automation pipelines for continuous delivery (CI/CD), and infrastructure provisioning tools like GoCD, Harness, and Terraform
• Write clean, efficient, and well-tested Python code for automation, tooling and service development.
• Manage and optimize relational or in-memory databases, including PostgreSQL, Redshift and Redis, ensuring high performance, reliability, and data integrity.
• Administer and finetune container orchestration platforms such EKS and ECS.
• Implement and manage serverless architectures leveraging AWS Lambda for various platform functionalities.
• Collaborate closely with development teams to ensure infrastructure aligns with application requirements and best practices.
• Lead efforts in defining and enforcing security best practices across the platform, including adherence to HIPAA standards, FISMA, SOC II, and FedRAMP compliance standards.
• Monitor systems performance, identify bottlenecks, and implement proactive solutions to ensure optimal operation and scalability.
• Participate in on-call rotations to provide operational support and incident response.
• Champion Agile/Scrum methodologies, actively participating in sprint planning, stand-ups, and retrospectives.
• Mentor junior developers and contribute to a culture of technical excellence and continuous improvement.
• Evaluate and recommend new technologies and tools to enhance platform capabilities and efficiency.
• Develop internal tooling and automation scripts using Python and work with SQL to support operational workflows.
• Implement observability (monitoring/logging/alerting) best practices for highly available SaaS services.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Requirements

• 8+ years of experience as a Platform Engineer, DevOps Engineer, or Site Reliability Engineer.
• Deep expertise in AWS infrastructure and services including but not limited to EC2, Lambda, ECS, EKS, RDS, S3, VPC, CloudWatch, SQS, SNS, IAM, Kinesis
• Excellent proficiency with Terraform, Python, SQL, and automation tooling.
• Extensive experience with Docker and container orchestration (Kubernetes/EKS).
• Solid understanding and hands-on experience with SQL, database administration (PostgreSQL preferred), and performance tuning
• Experience with CI/CD systems (e.g., GoCD, GitHub Actions, Harness).
• Proven experience in automating Observability & Monitoring (Grafana, Kibana, Prometheus), standardizing incident response for alerts to maintain SLAs and SLOs
• Hands-on experience in environments compliant with FISMA, SOC 2, and/or FedRAMP.
• Background in building highly scalable, performant SaaS platforms.
• Excellent communication, collaboration and problem-solving skills.
• Ability to work effectively with cross-functional teams, including developers, IT security & compliance, product manager, and scrum masters.
• Strong experience in production on call rotations and responding to alerts.

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.

Position Summary:

We are seeking a detail-oriented and analytical Manager, Pharmacy Pricing Appeals to join our Provider Relations team. In this role, you will be responsible for managing and resolving the interaction with the pharmacies related to pricing appeals and claims review requests submitted by the pharmacies or internal teams. This includes performing an initial review of the claim and associated pricing, providing the information to internal teams for review, managing any claim adjustments that may be needed, and communicating any necessary information back to the pharmacies. You will play a critical role in ensuring fair reimbursement practices and maintaining strong relationships with pharmacy partners. 

Position Responsibilities:

• Lead the review and improvement of the pharmacy pricing appeal process in coordination with the Analytics team.
• Lead the review and evaluation of the pricing appeal regulatory requirements with the Legal team.
• Manage intake pharmacy pricing appeals or claims reviews from the pharmacies or internal teams via the applicable intake methods required by internal processes and regulations. This involves managing applicable appeal in-boxes and intake methods.
• Evaluate pharmacy-submitted appeals to ensure they meet established criteria and provide the applicable information to the appropriate internal teams for review.
• Receive the internal claim pricing review and respond to the appealing pharmacy with the information.
• Manage the internal process to update any pricing or make claim adjustments as necessary.
• Collaborate with pharmacies and internal teams to reach equitable reimbursement outcomes.
• Provide appeal response information and feedback to the pharmacies as required.
• Provide clear and timely updates to pharmacies and other stakeholders regarding appeal statuses and outcomes.
• Maintain accurate records of appeals and generate reports on trends and discrepancies.
• Lead the development of and manage the claims review process at the NDC level.
• Support other projects as assigned by the Provider Relations team.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Minimum Qualifications:

• Bachelor’s degree required.
• 5+ yrs. of experience in reviewing claims or payment appeals in healthcare, pharmacy, PBM, or other relevant experience. Such prior experience in a pharmacy pricing appeals role includes experience in managing regular correspondence and communication with pharmacies.
• In-depth knowledge of pharmacy operations and drug pricing.
• Familiarity with PBMs and their role in pharmacy reimbursement.
• Strong analytical and problem-solving skills.
• Strong project management skills.
• Excellent communication and interpersonal abilities.
• Experience with and understanding of pharmacy claims processing, pharmacy adjudication systems, and reimbursement workflows.
• Knowledge of state or federal pricing appeal laws.
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.
• Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to pharmacy providers to close out contracts and tasks.
• Ability to work independently, track work/projects appropriately and remain on task.
• Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders.

Preferred Qualifications:

• Certification in pharmacy technician or related field is a plus.

Position Summary

The Pharmacy Value Programs Senior Project Manager will lead the development, execution, and continuous improvement of innovative pharmacy benefit cost‑savings programs across all lines of business, including Commercial, Exchange, Medicare, and Medicaid. In this highly cross‑functional role, the Program Manager partners closely with internal teams, external vendors, and pharmacy partners to design and implement strategic initiatives—from specialty pharmacy partnerships to benefit design optimization and manufacturer‑direct solutions—that reduce overall drug spend while maintaining or enhancing member experience. This role is responsible for maintaining detailed implementation plans, operational workflows, and training materials while ensuring program quality and compliance through structured audits and documentation. The Project Manager also collaborates with Analytics to produce opportunity assessments and savings reporting, and supports the commercialization of new offerings through pricing, marketing enablement, and RFI/RFP contributions. The ideal candidate brings deep experience in healthcare cost management, strong analytical capabilities, exceptional communication skills, and a strategic mindset with the ability to identify inefficiencies and drive long‑term product and process improvements in a fast‑paced environment.

Position Responsibilities:

• Program Development & Management: Collaborate with key stakeholders to develop and maintain new and existing drug cost containment programs for all lines of business (Commercial, Exchange, Medicare, and Medicaid). Programs include, but are not limited to, partnerships with innovative mail & specialty pharmacies, benefit design optimization, and integration with manufacturer direct offerings.
• Program Planning and Execution: Engage with appropriate stakeholders and cross-functional teams to ensure successful implementation and execution of programs.
• Program Maintenance: Regularly update and maintain comprehensive implementation plans, workflow guides, trainings, and other documentation.
• Quality Assurance: Implement quality control processes to ensure program compliance with established standards and guidelines. Conduct and document audits and work with appropriate stakeholders to implement corrective actions as needed.
• Vendor management: Own relationships with and provide oversight of third-party vendors (including pharmacies) to administer programs with emphasis on member experience and cost savings.
• Data Analytics & Reporting: Use reporting tools and partner with our Analytics team to develop and maintain opportunity analyses and ongoing savings performance reporting.
• Commercialization: Support the go-to-market strategy of savings product offerings including pricing, marketing, and implementation. Support RFI and RFP submissions.
• Continuous quality improvement: Evaluate evolving industry and market landscape and analyze prescription claims data to identify opportunities for improving existing products and developing new products. Supports quality improvement programs/projects as required. 

Required Qualifications:

• Bachelor’s Degree required
• 4+ years of experience applicable to health care cost management, such as in a health plan, PBM, value-based care, or managed care environment; consulting, advising, or tech enablement focused on the preceding areas also considered applicable
• Ability to balance multiple complex projects simultaneously with minimal direction
• Great time-management and organizational skills to manage multiple active projects simultaneously
• Exceptional written, verbal, and presentation skills
• Experience working with data reporting tools, conducting data analyses, and effectively consuming/interpreting data reports and visualizations

Preferred Qualifications:

• Master’s Degree in relevant field (PharmD, MBA, MHA/MHP, etc.)
• Experience with prescription drug channels and payment workflows (pharmacy reimbursement, rebate administration and GPO relations, regulatory requirements, etc.)
• Experience with health insurance or health benefits administration (pharmacy benefits in particular)
• Strong experience in developing, implementing, and using data and workflow management technology solutions (e.g., customer relationship management (CRM), Jira/Salesforce, collaborative Excel workbooks in SharePoint, etc.)
• Experience with programming languages relevant to data analytics, such as SQL or Python
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
• Ability to think strategically and identify inefficiencies, develop long-term solutions, and challenge and improve existing processes through automation and redesign
• Highly detail-oriented and analytical
• Ability to travel occasionally as needed for internal, client, and vendor/partner meetings

Position Summary

The Market Access Programs Senior Project Manager will lead the development, execution, and continuous improvement of innovative market access programs across all lines of business, including Commercial, Exchange, Medicare, and Medicaid. In this highly cross‑functional role, the Program Manager partners closely with internal teams, external vendors, and pharmacy partners to design and implement strategic initiatives—from specialty pharmacy partnerships to manufacturer‑direct solutions—that enhance member experience and reduce overall drug spend. This role is responsible for maintaining detailed implementation plans, operational workflows, and training materials while ensuring program quality and compliance through structured audits and documentation. The Project Manager also collaborates with Analytics to produce opportunity assessments and savings reporting, and supports the commercialization of new offerings through pricing, marketing enablement, and RFI/RFP contributions. The ideal candidate brings deep experience in healthcare cost management, strong analytical capabilities, exceptional communication skills, and a strategic mindset with the ability to identify inefficiencies and drive long‑term product and process improvements in a fast‑paced environment.

Position Responsibilities:

• Program Development & Management: Collaborate with key stakeholders to develop and maintain new and existing market access programs for all relevant lines of business. Programs include, but are not limited to, innovative pharmacy network configurations and partnerships with supply chain stakeholders.
• Program Planning and Execution: Engage with appropriate stakeholders and cross-functional teams to ensure successful implementation and execution of programs.
• Program Maintenance: Regularly update and maintain comprehensive implementation plans, workflow guides, trainings, rules sets, and other documentation as relevant and required.
• Quality Assurance: Implement quality control processes to ensure program compliance with established standards and guidelines. Conduct and document audits and work with appropriate stakeholders to implement corrective actions as needed.
• Vendor management: Own relationship with and provide oversight of third-party vendors and/or partners (pharmacy providers or manufacturers) to administer programs with emphasis on member experience and value capture for clients.
• Data Analytics & Reporting: Use reporting tools and partner with our Analytics team to develop and maintain opportunity analyses and ongoing savings performance reporting.
• Commercialization: Support the go-to-market strategy of program offerings including pricing, marketing, and implementation. Support RFI and RFP submissions.
• Continuous quality improvement: Evaluate evolving industry and market landscape and analyze prescription claims data to identify opportunities for improving existing programs and developing new programs and/or partnerships. Supports quality improvement programs/projects as required. 

Required Qualifications:

• Bachelor’s Degree required
• 4+ years of experience applicable to health care,, such as in a health plan, PBM, pharmacy, manufacturer, value-based care, or managed care environment; consulting, advising, or tech enablement focused on the preceding areas also considered applicable
• Ability to balance multiple complex projects simultaneously with minimal direction
• Great time-management and organizational skills to manage multiple active projects simultaneously
• Exceptional written, verbal, and presentation skills
• Experience working with data reporting tools, conducting data analyses, and effectively consuming/interpreting data reports and visualizations

Preferred Qualifications:

• Master’s Degree in relevant field (PharmD, MBA, MHA/MHP, etc.)
• Experience with prescription drug channels and payment workflows (pharmacy reimbursement, rebate administration and GPO relations, regulatory requirements, etc.)
• Experience with health insurance or health benefits administration (pharmacy benefits in particular)
• Strong experience in developing, implementing, and using data and workflow management technology solutions (e.g., customer relationship management (CRM), Jira/Salesforce, collaborative Excel workbooks in SharePoint, etc.)
• Experience with programming languages relevant to data analytics, such as SQL or Python
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
• Ability to think strategically and identify inefficiencies, develop long-term solutions, and challenge and improve existing processes through automation and redesign
• Highly detail-oriented and analytical
• Ability to travel occasionally as needed for internal, client, and vendor/partner meetings

Location: Remote or Hybrid (Local to NYC or Denver area)

As an Account Manager focused on PBA and Medicare, you'll be at the forefront of delivering seamless client experiences by managing benefit changes, implementing new plans, and ensuring pricing accuracy—all while driving impactful solutions that directly shape business success. You’ll lead key quality assurance initiatives, proactively identify claim discrepancies, and collaborate across teams to streamline processes, making a tangible impact on client satisfaction and operational efficiency. Your expertise will be essential in shaping client strategies, resolving complex issues, and upholding the values that keep Capital Rx ahead of the competition.

Position Responsibilities:

• Partner with clinical account manager (CAM) and account executive (AE) to manage clients through the entire lifecycle from implementation through go-live and renewal on a designated book of business
• Support implementation as a critical member of the 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, override requests, demos 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
• Travel requirements not to exceed 25%
• 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
• Responsible for relationship management and contribution to successful NPS and Account Management Survey results, along with retention support
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Qualifications / Profile:

• Undergraduate bachelor’s degree, with record of strong academic performance
• 5+ 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

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

Position Summary

Join our mission to transform our nation's healthcare system as a Senior Backend Software Developer. In this role you will assist in leading projects from design to delivery. Partner with product managers and designers to define requirements during discovery and planning. Collaborate with developers to deliver those requirements on time as new features or improvements to existing functionality. 

Why you’ll love working here

• We have a remote-first culture.
• You will make a tangible impact on society. Your code will directly improve healthcare experiences for millions.
• We are a late-stage startup with stability. We have startup energy with a focus on delivery, but healthy processes with a strong financial outlook that provides a sense of security. 

Position Responsibilities

In this role, you’ll combine technical leadership with hands-on coding to build scalable, high-impact healthcare technology. You will: 

• Exercise leadership over features from design to delivery. 
• Be a partner to product, design, and quality assurance team members. 
• Become a subject matter expert on your team’s products. 
• Provide technical support to cross-functional team members and stakeholders. 
• Expand Judi, our web-based enterprise health platform, using Python, AWS services, and other technologies. 
• Work in an Agile/Scrum environment. 
• Code of Conduct: Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. 

Minimum Qualifications

We’re looking for someone who brings a mix of technical expertise, problem-solving ability, and collaborative spirit: 

• 7+ years of job-related experience.
• Desire to work at a health tech company.
• Strong Python (Flask / SQLAlchemy) experience.  
• Advanced PostgreSQL database knowledge (e.g., common table expressions, windowing functions, views, stored procedures, full-text or geospatial indexing).
• Experience with infrastructure as code using AWS, Terraform, or similar technologies.
• Experience writing unit tests.
• Git expertise and experience working in a mono repo.
• Able to demonstrate agency, urgency, and ownership over delivering quality work.
• Strong written and verbal communication skills.
• Previous Pharmacy Benefits Manager (PBM) experience is a plus.  

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.

Position Summary:

We are seeking a passionate and driven Product Manager with a strong background in consumer-facing mobile applications to drive the vision, strategy, and roadmap for Judi Health’s member-facing app experiences. This role will focus on building intuitive, high-impact mobile solutions that simplify care navigation, enhance engagement, improve health outcomes, and help lower the overall cost of care.

Position Responsibilities:

• Lead the product strategy, development, and enhancements of Judi Health’s Product offerings
• Develop business requirements and specification documents, working with our operations and client management and sales teams
• Accountable for on-time and accurate delivery of product features.
• Participate in product planning, roadmap development, and long-term strategy planning
• Effectively manage and meet stakeholders’ priorities and expectations.
• Support collecting and acting on feedback from internal stakeholders and external clients to iterate and improve upon existing products and ideate and anticipate new products
• Perform backlog grooming, epic planning, refinement, and other scrum events.
• Perform demos of in-market product to clients and prospects.
• Manage and execute day-to-day project management functions with regards to the specific products currently under development
• Analyze product data to derive insights to assist in the prioritization and post release optimization of the products
• Work with design team to conduct user experience testing and research
• Conduct user testing of prior to release to the customer.
• Support general business needs, as required
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• Bachelor’s degree, Masters Preferred
• 4+ years of experience in Product Management role
• 2+ years of experience in apps products required
• Proven track record of launching and scaling consumer products. Deep customer empathy to deliver exceptional member experiences.
• Experience with pharmacy benefit management or health insurance preferred
• Experience with agile framework; certified Scrum Product Owner is a plus
• Comfort or experience in a fast-paced, growing environment
• Intellectual and professional curiosity
• Highly analytical; experience using analytical tools to manage customer engagement and identify key insights
• Excellent communication and collaboration skills
• Ability to manage conflicting priorities in a deadline driven environment.
• Strong attention to detail and project management skills

Position Summary:

We are seeking a passionate and driven Product Manager with a strong background in consumer-facing mobile applications to drive the vision, strategy, and roadmap for Judi Health’s member-facing app experiences. This role will focus on building intuitive, high-impact mobile solutions that simplify care navigation, enhance engagement, improve health outcomes, and help lower the overall cost of care.

Position Responsibilities:

• Lead the product strategy, development, and enhancements of Judi Health’s Product offerings
• Develop business requirements and specification documents, working with our operations and client management and sales teams
• Accountable for on-time and accurate delivery of product features.
• Participate in product planning, roadmap development, and long-term strategy planning
• Effectively manage and meet stakeholders’ priorities and expectations.
• Support collecting and acting on feedback from internal stakeholders and external clients to iterate and improve upon existing products and ideate and anticipate new products
• Perform backlog grooming, epic planning, refinement, and other scrum events.
• Perform demos of in-market product to clients and prospects.
• Manage and execute day-to-day project management functions with regards to the specific products currently under development
• Analyze product data to derive insights to assist in the prioritization and post release optimization of the products
• Work with design team to conduct user experience testing and research
• Conduct user testing of prior to release to the customer.
• Support general business needs, as required
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• Bachelor’s degree, Masters Preferred
• 4+ years of experience in Product Management role
• 2+ years of experience in apps products required
• Proven track record of launching and scaling consumer products. Deep customer empathy to deliver exceptional member experiences.
• Experience with pharmacy benefit management or health insurance preferred
• Experience with agile framework; certified Scrum Product Owner is a plus
• Comfort or experience in a fast-paced, growing environment
• Intellectual and professional curiosity
• Highly analytical; experience using analytical tools to manage customer engagement and identify key insights
• Excellent communication and collaboration skills
• Ability to manage conflicting priorities in a deadline driven environment.
• Strong attention to detail and project management skills

Position Summary:

We are seeking a Tableau Developer/Analyst who will own the design, development and evolution of high-quality dashboards and reports that drive client reporting and internal decision-making. This role emphasizes Tableau development in Tableau Cloud/Server, strong SQL skills against Snowflake, and close collaboration with Client Services and analytics stakeholders. Candidates will contribute to department projects by creating reliable, performant, and consistent visualizations aligned with governed metric definitions.

Why you’ll love working here:

• We translate complex questions into clear, actionable insights that help the organization move faster and smarter.
• We build reliable, scalable data products that make decision‑making consistent and trustworthy across teams.
• We collaborate effectively with stakeholders to ensure analytics work aligns with real needs and drives meaningful improvement.

Position Responsibilities:

Dashboard & Report Development

• Design, develop, and publish Tableau dashboards and data visualizations in Tableau Cloud/Server to support client reporting and internal analytics.
• Translate stakeholder requirements into clear, well-structured dashboards, optimizing usability (filters, parameters, navigation) and ensuring consistency of metric definitions.
• Package, version, and document in Confluence and GitHub; follow established branching and review practices.

Maintenance & Enhancement

• Own the ongoing health and evolution of Tableau reporting assets, including standardization, metric integrity, and user experience improvements across teams.
• Implement lightweight data quality checks and validation steps to confirm measures and dimensions are accurate and aligned to governed definitions.
• Coordinate updates and releases with the Analytics Platform team, including change notes and stakeholder walkthroughs.

Performance & Data Access

• Develop efficient data sources and queries for Tableau using Snowflake; apply best practices for extracts vs live, row-level security, and query optimization.
• Monitor dashboard performance and usage, iterating to reduce load times and improve responsiveness
• Partner with Analytics Engineering on data modeling and definitions as needed for Tableau consumption.

Stakeholder Collaboration

• Collaborate with Client Services and business stakeholders to translate business questions into reporting requirements, iterate on solutions, and run demos to gather feedback and drive continuous improvement.
• Provide training and support for power users and business users adopting new dashboards.
• Contribute to a culture of data-driven decision-making across teams.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Minimum Qualifications:

• 1–3 years of experience in data analytics/business intelligence or a related field (matching current Analyst level).
• Expertise in Tableau Desktop and publishing to Tableau Cloud/Server.
• Strong SQL skills; experience with Snowflake preferred.
• Experience with GitHub for version control and collaboration.
• Familiarity with dbt concepts and governed metric definitions.
• Preferred domain knowledge in PBM/pharmacy/healthcare; experience with client reporting strongly preferred.
• Strong organizational skills and attention to detail; effective communicator with non-technical stakeholders.

Position Summary

We are seeking an experienced and strategic Project Manager to lead the delivery of high‑impact, cross‑functional initiatives. This role is responsible for managing multiple complex projects from inception through execution, ensuring alignment with business objectives, compliance standards, and operational best practices. The ideal candidate brings strong communication, stakeholder management, problem‑solving, and risk mitigation skills, with a proven ability to deliver results in a fast‑paced environment.

Position Responsibilities:

• Manage concurrent client audits or team projects, coordinating with internal and external stakeholders to ensure on‑time, on‑scope delivery.
• Develop, maintain, and execute detailed project plans, including scope, timelines, milestones, resource allocation, and task assignments across simultaneous audits and initiatives.
• Drive end‑to‑end project execution from initiation through closeout, ensuring alignment with business objectives and contractual requirements.
• Serve as the primary point of contact in external auditor and consultant meetings, leading kickoffs, clarifying scope and procedures, and managing expectations.
• Monitor project progress and performance, proactively managing risks, issues, dependencies, and scope changes.
• Collaborate closely with cross‑functional subject matter experts (e.g., Account Management, Analytics, Network, Provider Relations, Product, Compliance, etc.) to gather deliverables, review findings, provide responses, complete corrective actions, and ensure follow‑ups are owned and closed.
• Maintain clear, consistent communication through status updates, dashboards, and presentations for stakeholders and leadership.
• Build and maintain strategic relationships with external consultants, auditors and internal teams.
• Ensure quality, compliance, and governance by maintaining complete project documentation, leveraging project management tools (e.g., Jira, Confluence, Asana), and driving continuous process improvement.
• Support general business needs, as required.
• Responsible for the adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Required Qualifications:

• Bachelor’s degree in a related field
• 3+ years of proven experience in project management
• PMP or equivalent certification is strongly preferred
• Experience in healthcare, pharmacy benefit management, pharmacy claims audit, or health tech environments is highly desirable
• Proficiency with project management tools (e.g., Jira, Confluence, Asana, etc.).
• Track record of leading cross-functional projects, driving high performance, meeting deadlines, and executing on deliverables
• Strong attention to detail with an intellectual and professional curiosity along with a passion for continuous improvement
• Ability to balance multiple complex projects simultaneously
• Exceptional communication and stakeholder management skills
• Extremely flexible, highly organized, and able to shift priorities easily

Position Summary

We are seeking a highly analytical and detail‑oriented Analyst to join our team. This role plays a key part in validating and coding audit deliverables, developing performance monitoring reporting, quantifying financial impact, and driving efficiency through automation and advanced analytics. The ideal candidate brings experience with internal controls, audit testing, and risk assessment, along with a proven ability to deliver high‑quality results in a fast‑paced, collaborative environment.

Position Responsibilities:

• Research and analyze pharmacy claims to ensure accuracy and contractual compliance across benefit setup, pricing, and guarantees
• Perform audit risk assessments, annual logic reviews and ongoing monitoring activities
• Analyze, reconcile and validate large datasets across multiple internal systems; develop and maintain SQL/Python queries for audit reporting and performance monitoring
• Create audit deliverable reporting, quantify financial impact of potential and confirmed audit findings, and build dashboards to identify trends and risks
• Identify and implement automation and process improvements across audit, reporting, and reconciliation workflows
• Maintain and enhance code, reporting tools, and dashboards to improve reliability, efficiency, and scalability
• Define and document technical requirements, data specifications, and methodologies to support transparency and repeatability
• Collaborate with internal and technology teams to improve data quality, workflows, and controls
• Provide ad-hoc analysis to support evolving business and audit needs
• Responsible for the adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Required Qualifications:

• Bachelor’s degree in a quantitative or business-related field (e.g., Actuarial Science, Statistics, Economics, Finance, Data Analytics, or Business Administration)
• 2+ years of of experience in data analytics, audit, or a related role
• Experience in healthcare, PBM, or pharmacy claims; knowledge of pharmacy benefits, pricing, guarantees, and pharmacy claims analysis preferred
• Proficiency with SQL (Snowflake preferred), Excel, Tableau
• Familiarity with Python and project management/version control tools (e.g., Jira, Confluence, GitHub)
• Strong attention to detail with an intellectual and professional curiosity along with a passion for continuous improvement
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
• Effective communicator with both technical and non-technical stakeholders
• Extremely flexible, highly organized, and able to shift priorities easily

Location: Hybrid (Local to NYC)

Position Summary: 

The Provider Relations Specialist provides essential credentialing review and management to support the Capital Rx networks of pharmacies. This work involves deciding whether pharmacies meeting Capital Rx’s credentialing requirements allowing for inclusion in the Capital Rx pharmacy networks and maintaining the information related to credentialing. The ideal candidate will have experience in credentialing providers, managing reporting requests, and contribute to scalable solutions to streamline processes.  

Position Responsibilities: 

• Manage the standard credentialing review process for applicable pharmacies for inclusion in the provider networks and maintain the information related to credentialing so that Capital Rx has the most relevant information available. This includes getting applicable licenses and certificates of insurance from pharmacies as well as verifying eligibility in the NCPDP database and federal and state websites (e.g. OIG, GSA, SAM) and using that information to decide whether the pharmacy meets the credentialing requirements for Capital Rx.  

• Manage, review and decide whether the applicable pharmacies are valid by reviewing exclusion lists on an ongoing basis to identify any excluded pharmacies and referring those pharmacies to the appropriate team members/departments for removal. 

• Manage the development and maintenance of a credentialing database to ensure proper tracking of all relevant credentialing information. 

• Manage credentialing reporting requests. 

• Gather and track annual pharmacy required attestations. 

• Manage and review development and implement of credentialing policies and procedures. 

• Gather pertinent information from pharmacies regarding services offered and opportunities and provide direct contracting support to Provider Relations leadership as needed. 
• Provide other assistance as assigned to the Provider Relations team. 

Required Qualifications: 

• 2+ yrs. of experience in healthcare, pharmacy credentialing, contracting, provider relations, pharmacy, account management or other relevant experience. 

• Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to pharmacy providers to close out contracts and tasks. 

• Ability to work independently, track work/projects appropriately and remain on task. 

• Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders. 
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint. 

Preferred Qualifications: 

• PBM and pharmacy technician experience preferred 

• Bachelor’s degree preferred 

Position Summary: 

The UX/UI Designer is a skilled contributor responsible for delivering user-centered designs for assigned product features and collaborating closely with cross-functional teams. This role emphasizes strong execution, attention to detail, and growth in design craft while supporting design system adoption and contributing to team success. Mid-Level designers participate in research, prototyping, and design execution, with opportunities to mentor junior peers informally. 

Position Responsibilities: 

• Design user interfaces and experiences for assigned features, ensuring usability and visual consistency. 

• Conduct usability testing and apply findings to improve design. 

• Create wireframes, prototypes, and high-fidelity designs that align with product requirements. 

• Ensure designs meet accessibility and brand standards. 

• Contribute to design system components and maintain consistency across projects. 

• Collaborate with product managers, engineers, and other designers to deliver high-quality solutions. 

• Participate in design critiques and provide constructive feedback to peers. 

• Stay updated on UX/UI trends and best practices to continuously improve design quality. 

• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance. 

Required Qualifications: 

• Bachelor’s Degree, certificate, or equivalent work experience. 

• 3–5 years' experience in a UX or Product Designer role. 

• Proficiency in Figma and other UX/UI design tools. 

• Experience designing responsive interfaces and applying accessibility standards. 

• Portfolio demonstrates strong UX/UI principles and real-world projects. 

• Basic knowledge of HTML and CSS; familiarity with design-to-development handoff. 

• Strong communication and collaboration skills. 

• Ability to thrive in a fast-paced environment and adapt to changing priorities. 

Position Summary:

As an individual contributor on the Product team, you will pay a critical role in contributing to the success of Capital Rx. The Capital Rx Product team seeks individuals who are passionate about improving the landscape of pharmacy prior authorizations, while providing superior service. The expectations for growth in this role are to push beyond the core data and reporting and to serve as an expert across all domains of Judi, our Enterprise Health Platform.

Position Responsibilities:

• Provide subject matter expertise support on Judi’s function and reporting capabilities related to prior authorization
• Take accountability for accurate translation of reporting requirements for Capital Rx’s customers 
• Support analytics and reporting needs for the prior authorization team and related groups
• Own swift resolution and clear communication of critical reporting issues
• Present analysis results clearly
• Assist in testing of new Judi functionality to ensure enhancements are functioning as expected and accurately processing claims transactions
• Build key cross-functional relationships with other internal teams
• Provide virtual and in person product demonstrations
• Note: Role may periodically require meeting participation, service support or other requirements outside of standard business hours

Minimum Qualifications:

• Bachelor’s degree, with record of strong academic performance in Computer Science, Actuarial Science, Statistics, or Economics or equivalent work experience strongly preferred
• 2+ years of proven experience in data analytics and reporting required
• 2+ years of experience in Structured Query Language (SQL) required
• 2+ years of experience with ETL or ELT preferred
• 2+ years of PBM, pharmacy, health plan, or related experience preferred
• 1+ years working with JSON or other data-exchange format tools preferred
• 1+ year of Python, R, or similar programming experience preferred
• Experience presenting analysis to clients and/or management preferred
• Proficient in Microsoft Excel
• Extremely organized, detail-oriented, and able to easily pivot priorities
• Ability to work effectively with virtual teams
• Ability to travel 5-10%

Position Summary 

We are seeking a skilled and passionate Senior Scrum Master to support the development teams in applying agile practices effectively with a focus on the Scrum framework. Candidates should foster a culture of continuous improvement, collaboration, and transparency, while guiding teams through agile maturity and delivering high-quality outcomes. As a Senior Scrum Master candidates are expected to extend their influence beyond their specific teams and help guide multi-team “pods”, bring new perspective and experience to our Agile team and help grow other more junior Scrum Masters through mentoring and guidance. 

Position Responsibilities: 

Agile Coaching & Facilitation 

• Facilitate Scrum events and coach teams to self-organize and continuously improve. 
• Design and lead retrospectives tailored to team needs. 
• Assess team Agile maturity and adjust coaching approach to match strengths and weaknesses 
• Guide teams in applying lean and agile principles to improve delivery. 
• Support multiple interdependent teams in effectively working together in concert 

Team & Stakeholder Engagement 

• Foster collaboration between Scrum Teams and stakeholders. 
• Mediate conflicts and support team dynamics to ensure a healthy team environment. 
• Support onboarding and agile adoption for new team members and teams. 

Process Improvement & Metrics 

• Identify and remove impediments to team progress. 
• Leverage empirical data to drive continuous improvement. 
• Prepare and present sprint reports including velocity, capacity, and predictability metrics. 
• Build and maintain workflows and automation to enhance team and department efficiency. 

Product & Planning Support 

• Collaborate with product teams on backlog management, coaching on prioritization best practices 
• Assist in roadmap development and release forecasting using agile metrics. 
• Promote best practices in lean, iterative software delivery. 
• Develop working knowledge of our products to provide targeted coaching, help bridge gaps between teams working on related features, and help provide knowledge and context to others.

Agile Team Growth 

• Share discussion topics and tactics to improve the effectiveness of the overall Agile team.
• Help more junior Scrum Masters on their own professional journey through mentoring and less formal guidance.
• Coordinate with other Scrum Masters and Project Managers on larger projects or implementations.

Facilitates Quarterly Planning for team(s) 

• Tracks quarterly goals for team(s) 

A Successful Contributor has: 

• Deep knowledge of multiple agile frameworks and how to apply them effectively. 
• Experience in teaching, organizing, and sharing specific educational information on Scrum and agile frameworks. 
• Facilitation skills. The ablity to build consensus and alignment, mediate and diffuse conflict, and highlight innovative solutions. 
• Understanding of business strategy techniques and their impacts to product delivery (i.e. Lean Startup and Design Thinking). 
• Experience implementing Forecasting and Release Planning Practices such as Quarterly planning and road mapping iterative releases using data on velocity, capacity, and predictability. 
• Inductive Reasoning abilities and can use a combination of data points to form conclusions and rules in sprint planning. 
• Understanding of emergent architecture and how to apply it to iterative development and incremental delivery. 
• Understanding of CI/CD techniques and how these can be used effectively to deliver complex software solutions. 
• Proficient with building complex automations that can be applied to increase the Scrum Team’s efficiency in following the Scrum framework. 
• Skilled communicator, with a focus on commitment, courage, focus, openness, and respect. 
• Experience and proficiency in guiding teams towards self-organization and accountability. 
• Leadership qualities and experience, enabling them to grow individual Scrum Masters and the broader team 

Required Qualifications: 

• Bachelor’s Degree in business, information technology, or 5 years’ work experience in related field required. 
• 5+ years working in Scrum Master role.  
• Certified Scrum Master (CSM) or equivalent certification. 

Position Summary

As the Total Rewards Analyst in a fast-paced, high-growth, health tech environment, you will be key in ensuring seamless benefits, compensation, payroll and HRIS administrative processes. This position manages job descriptions, enhances internal workflows, maintains compliance, analyzes and manages employee contributions, and supports company culture through effective people-centered practices.  The ideal candidate is detail-oriented, process-driven, and passionate about creating a smooth employee experience. This role provides administrative and analytical support to the human resource function as needed, including record-keeping, file maintenance, and HRIS entry.

Position Responsibilities:

• Support the Head of Benefits and Compensation with creating project plans for the team, defining milestones, and coordinating with stakeholders to deliver initiatives.
• Support team members by mapping, documenting and standardizing current workflows.
• Analyze current HR workflows to identify bottlenecks, redundancies, and opportunities for automation or improvement.
• Tracks and analyzes employee contributions, monitors deductions against payroll register, and identifies and documents adjustments to resolve discrepancies.
• Identify primary duties and responsibilities of current jobs, assess the nature of work, and research and map them to an occupational classification.
• Manage the Benefits inbox by addressing employee inquiries regarding compensation, benefits, and payroll and escalate complex issues to the designated subject matter expert.
• Conduct regular audits of payroll, benefits or other HR programs to ensure data accuracy, compliance with regulations, and recommend corrective action.
• Maintain, organize, and ensure the confidentiality of documents related to benefits, compensation and payroll.
• Ensure HR processes meet both organizational goals and health regulatory requirements.
• Collaborate with cross-functional teams to ensure consistent human resource practices.
• Monitor state and local employment laws, including minimum wage adjustment, pay transparency, leave programs, determine their impact on company policy, distribute updates, and revise process workflow.
• Maintain HRIS by ensuring employee information such as benefit, equity, job titles, address, and bonuses is correct before each pay cycle.
• Responsible for adherence to the Judi Health Code of Conduct, including reporting of non-compliance.
• Performs other related duties as assigned.

Required Qualifications:

• Bachelor’s degree required.
• 2+ years of experience in Human Resources.
• High level of integrity and discretion when handling confidential information.
• Knowledge of employment law and HR compliance standards.
• Exceptional attention to detail, with the ability to manage multiple priorities and deadlines.
• Experience working in HRIS or HCM systems is strongly preferred. Previous experience with UKG is a plus.
• Ability to work independently and take on increasing responsibilities over time.
• Strict adherence to confidentiality and professionalism.
• Strong problem-solving skills and sound judgment.
• Strong communication and organizational skills with a customer service mindset.
• Strong ability to use MS Office products.
• Flexibility to adapt to shifting priorities in a fast-paced environment.

Position Summary:

Responsible for taking incoming requests for first, second level and external appeals while ensuring high level of customer service and maximizing productivity. Work with appeals team for multiple lines of business such as Commercial, Exchange and Medicare, ensuring the proper submission of appeals for review by pharmacist and medical directors.

Position Responsibilities:

• Maintain quality and productivity standards for all cases reviewed while meeting established turnaround time requirements.
• Remain current on all communications and updated processes relayed through multiple communication channels and apply to daily responsibilities.
• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and policies.
• Review all cases received, to verify if case meets qualifications for appeal review.
• Performs triple check to ensure quality reviews and handling in accordance with policies and procedures.
• Updates case types, sends appeal acknowledgements, and submits case information to independent review organizations.
• Communicate effectively with appeal pharmacists regarding internal and external appeals.
• Make verbal outreach attempts to obtain necessary information for case review and record accurate information obtained on the call.
• Exhibit excellent phone and communication skills while providing complete and accurate information to members and providers.
• Performs all other related duties as assigned

Minimum Qualifications:

• 1 + years’ experience working as a certified pharmacy technician in a managed care or PBM setting required.
• Active, unrestricted certified pharmacist technician license required.
• Excellent organization details and strong detail orientation.
• Strong oral and written communication skills.
• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven environment with shifting priorities.
• Ability to work 12pm-9pm EST hours

Preferred Qualifications:

• Experience working with commercial and medicare appeals preferred

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

Remote, US Salary Range
$60,000.00 - $65,000.00  USD
New York, NY Salary Range
$78,800.00 - $98,500.00 USD
Denver, CO Salary Range
$72,000.00 - $90,000.00 USD

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.

Position Summary: 

The Provider Relations Specialist provides essential credentialing review and management to support the Capital Rx networks of pharmacies. This work involves deciding whether pharmacies meeting Capital Rx’s credentialing requirements allowing for inclusion in the Capital Rx pharmacy networks and maintaining the information related to credentialing. The ideal candidate will have experience in credentialing providers, managing reporting requests, and contribute to scalable solutions to streamline processes.  

Position Responsibilities: 

• Manage the standard credentialing review process for applicable pharmacies for inclusion in the provider networks and maintain the information related to credentialing so that Capital Rx has the most relevant information available. This includes getting applicable licenses and certificates of insurance from pharmacies as well as verifying eligibility in the NCPDP database and federal and state websites (e.g. OIG, GSA, SAM) and using that information to decide whether the pharmacy meets the credentialing requirements for Capital Rx.  

• Manage, review and decide whether the applicable pharmacies are valid by reviewing exclusion lists on an ongoing basis to identify any excluded pharmacies and referring those pharmacies to the appropriate team members/departments for removal. 

• Manage the development and maintenance of a credentialing database to ensure proper tracking of all relevant credentialing information. 

• Manage credentialing reporting requests. 

• Gather and track annual pharmacy required attestations. 

• Manage and review development and implement of credentialing policies and procedures. 

• Gather pertinent information from pharmacies regarding services offered and opportunities and provide direct contracting support to Provider Relations leadership as needed. 
• Provide other assistance as assigned to the Provider Relations team. 

Required Qualifications: 

• 2+ yrs. of experience in healthcare, pharmacy credentialing, contracting, provider relations, pharmacy, account management or other relevant experience. 

• Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to pharmacy providers to close out contracts and tasks. 

• Ability to work independently, track work/projects appropriately and remain on task. 

• Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders. 
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint. 

Preferred Qualifications: 

• PBM and pharmacy technician experience preferred 

• Bachelor’s degree preferred 

Location: Remote 

Position Summary: 

Join our Scalability team as a Senior Scalability Engineer focused on streaming and realtime systems. In this role, you will own the architecture and expansion of our streaming data infrastructure, including WAL-based database replication, change data capture (CDC) systems, and realtime event processing. Your work will handle systems processing hundreds of thousands to millions of records per batch while maintaining strict ordering guarantees and exactly-once semantics. Working closely with our clients and cross-functional teams, you'll build foundational streaming infrastructure while partnering directly with product teams to implement realtime capabilities that power critical business workflows. 

Position Responsibilities: 

In this role, you'll provide technical leadership while delivering hands-on solutions for high-impact performance challenges. You will: 

• Own streaming infrastructure: Design, implement, and expand WAL-based replication systems that process database changes through Kinesis to Snowflake and Redshift, handling millions of records while maintaining strict ordering and delivery guarantees. 
• Build CDC systems: Architect and implement change data capture infrastructure for cross-platform data synchronization, enabling realtime analytics and event-driven workflows across the organization. 
• Develop shared libraries: Create reusable Kinesis/SNS consumer patterns and libraries used across multiple teams, establishing best practices for event processing, error handling, and observability. 
• Partner with product teams: Work directly with teams to design and implement realtime data processing solutions tailored to their business needs, providing technical guidance and hands-on support. 
• Ensure data reliability: Implement exactly-once processing semantics, dead letter queues, retry strategies, and monitoring to guarantee data integrity across streaming pipelines. 
• Build observability: Develop monitoring, alerting, and dashboards for streaming pipelines to track throughput, lag, data quality issues, and system health using the LGTM stack.  
• Demonstrate technical leadership: Mentor engineers on streaming architecture patterns, lead design reviews for event-driven systems, and represent the Scalability team in cross-functional planning. 
• Make strong architectural choices through careful evaluation and prior experience with distributed systems.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance. 

Required Qualifications: 

• 10+ years of software engineering experience with demonstrated progression into technical leadership roles. 
• 3+ years of experience leading technical initiatives, architecting distributed systems, or serving as a subject matter expert on streaming infrastructure. 
• Strong expertise in Python (Flask/SQLAlchemy) for production applications. 
• Deep PostgreSQL knowledge: Understanding of write-ahead logs, replication, logical decoding, and change data capture mechanisms.
• Production streaming experience: Proven track record building and operating high-throughput streaming systems using Kinesis, Kafka, or similar event streaming platforms. 
• Distributed systems expertise: Strong understanding of ordering guarantees, exactly-once semantics, partition strategies, backpressure handling, and fault tolerance patterns. 
• AWS experience: Production experience with Kinesis, S3, SNS/SQS, Lambda, ECS, and data pipeline orchestration.  
• Data warehouse knowledge: Experience loading data into Redshift, Snowflake, or similar analytical databases.  
• Systems thinking: Ability to design resilient, observable streaming architectures that balance throughput, latency, and reliability.  
• Collaboration and communication: Strong written and verbal communication skills with ability to work autonomously while driving proactive collaboration in a remote environment. 

(Optional) Preferred Qualifications:   

• Rust development experience or strong interest in learning Rust for high-performance systems.
• Infrastructure as code: Experience with Terraform or similar IaC tools for managing cloud infrastructure. 
• Observability tools: Hands-on experience with Grafana, Prometheus, Loki, or similar monitoring/alerting platforms.  
• Event-driven architectures: Background designing event sourcing, CQRS, or other event-driven patterns.
• Previous Pharmacy Benefits Manager (PBM) or healthcare technology experience. 

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. 

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

Location: Remote (For Non-Local) or Hybrid (Local to NYC, Denver, or Charlotte)

Position Responsibilities:

• Support RFP/RFI opportunities for new and renewal PBM opportunities with low to moderate complexity.
• Comply fully with Capital Rx’s policies and procedures for proposal development.
• Support the creation and maintenance of consultant templates for assigned channel partners.
• Create and refine SOPs to support RFP response development and submission working in collaboration with proposal managers and directors.
• Within 9-12 months following hire date, demonstrate mastery of Capital Rx’s products, services, and financial model to complete assignments with minimal oversight.
• Comply with Capital Rx’s time and attendance policies for all salaried employees, including working a base of 40 hours per week.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
• Support the management of the RFP response database by returning new and revised responses to the RFP Content Manager.
• Assist in the creation and ongoing updates/edits to new RFP content.
• Help obtain and catalog ancillary RFP samples and attachments.
• Assist Content Manager with day-to-day maintenance of RFP library content (Qvidian).
• Assist Content Manager with maintenance of SME list.
• Contribute ideas for improvement across proposal & underwriting department including content management processes or tools.

Minimum Qualifications:

• Undergraduate bachelor’s degree, with record of strong academic performance in English, Journalism, Marketing or Communications
• 1+ years of proven experience in proposal writing, project management, or benefits consulting
• Attention to detail & commitment to delivering high quality work product
• Extremely flexible, highly organized, and able to shift priorities easily
• Ability to lead multiple projects simultaneously and balance a range of key internal and external stakeholders
• Track record of supporting multiple projects simultaneously, driving high performance, meeting deadlines, and executing on deliverables
• Proficient in Microsoft Office, Adobe, and other editing software
• Experience with RFP library software such as Qvidian, Loopio, Responsive, Expedience, etc. preferred
• Knowledge of healthcare industry trends and best practices
• Ability to write in plain language
• Exceptional written and verbal communication skills, including technical copy editing
• Passion for learning, including intricacies of pharmacy benefits products

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

Remote, US Salary Range
$75,000.00 - $87,000.00 USD  
New York, NY Salary Range
$74,000.00 - $92,500.00 USD  
Denver, CO Salary Range
$67,600.00 - $84,500.00 USD  

Benefits

Judi Health provides all full-time and part-time benefit-eligible employees with the ability to elect medical and pharmacy coverage, dental insurance, vision insurance, accidental injury insurance, critical illness insurance, hospital indemnity insurance, and flexible spending accounts. Full-time employees also have access to a health savings account, voluntary life insurance, and voluntary accidental death and dismemberment insurance for themselves and their eligible dependents.

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.

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.

Position Summary:

Join our first-of-its-kind Integrated Benefits team as a Benefit Operations Specialist, where you will play a pivotal role in delivering comprehensive medical and pharmacy benefit programs for Judi Health clients. You will lead benefit configuration, claims testing, and quality assurance processes, ensuring accuracy and efficiency across all implementations. This position offers the opportunity to influence operational best practices and contribute to a team that is redefining how integrated benefits are delivered in the healthcare space.

Position Responsibilities:

• Responsible for all aspects of benefit configuration, including new plan setup, plan change setup, claims testing, and regular audits
• Drives cross-functional collaboration with the product/dev team as well as additional stakeholder teams to ensure client customized requests are configurable for both new plan setups and plan changes
• Clearly communicate benefit configuration setup and testing process or specific test claims to clients in a concise way that can be understood by users who are not experts in benefit areas
• Make recommendations to streamline the work processes and systems that impact plan/benefit design to create efficiency and quality outcomes
• Works cross-functionally to create new benefit options aligning with market needs, including expansion in government programs
• Develop standards and custom batch testing scenarios and inputs, reviewing test claims output to validate claim accuracy against the clients’ benefit design
• Develops standard policy and procedures, training materials and provide education for training and presentation to cross-functional teams
• Maintain acceptable and appropriate quality levels and production SLA response time
• Participate in client meetings to assess new client benefit information or change requests to ensure design of Judi logic ties to the benefit configuration intended to meet client needs
• Partner with leadership to develop benefit plan designs and ensure that the plan designs meet client requests, Health Plan strategic/business parameters, and all regulatory and other oversight agencies’ requirements
• Partner with Client Services team as clients go live and troubleshoot benefit-related discrepancies, errors, and problems
• Support general business or team needs, as assigned
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Qualifications:

• Bachelor’s degree preferred
• 5+ years of TPA / health plan experience in Medical Benefit configuration, benefit testing, claims monitoring, SPD creation, Medical Coding or other applicable department needs
• 3+ years of experience with Cigna a plus
• Pharmacy, Dental, or Vision experience a plus
• Self-funded plans, Medicare/Government programs and ERISA experience preferred
• Tremendous attention to detail, ability to shift priorities easily and ability to work in high paced, deadline drive environment.
• Exceptional written and verbal communication skills
• Experience working with product/dev teams and familiarity with Agile, preferred
• Preferred: experience working with structured or unstructured data in Excel, SQL, and other data visualization tools

Certifications:

• IFEBP certification a plus

Position Summary: 

We are seeking a skilled and passionate Scrum Master to support the development teams in applying agile practices effectively, with a focus on the Scrum framework. This role will foster a culture of continuous improvement, collaboration, and transparency, while guiding teams through agile maturity and delivering high-quality outcomes. 

Position Responsibilities: 

Agile Coaching & Facilitation 

• Facilitate Scrum events and coach teams to self-organize and continuously improve. 
• Design and lead retrospectives tailored to team needs. 
• Conduct quarterly team health checks and maturity assessments. 
• Guide teams in applying lean and agile principles to improve delivery. 

Team & Stakeholder Engagement 

• Foster collaboration between Scrum Teams and stakeholders. 
• Mediate conflicts and support team dynamics to ensure a healthy team environment. 
• Support onboarding and agile adoption for new team members and teams. 

Process Improvement & Metrics 

• Identify and remove impediments to team progress. 
• Leverage empirical data to drive continuous improvement. 
• Prepare and present sprint reports including velocity, capacity, and predictability metrics. 
• Build and maintain workflows and automation to enhance team efficiency. 

Product & Planning Support 

• Collaborate with product teams on backlog management, coaching on prioritization best practices.
• Assist in roadmap development and release forecasting using agile metrics.
• Promote best practices in lean, iterative software delivery.
• Build foundational product knowledge to provide targeted coaching and help bridge gaps between teams working on related features.

• Tracks quarterly goals for team(s)

A Successful Contributor has: 

• Practical experience with multiple agile frameworks and their effective application. 
• Strong facilitation and conflict resolution skills. 
• Experience teaching and mentoring on Scrum and agile principles. 
• Understanding of business strategy techniques like Lean Startup, MVP vs MMF / MMP, and Prioritization Matrices.
• Experience with forecasting and release planning using agile metrics. 
• Knowledge of CI/CD and emergent architecture in iterative development. 
• Ability to build simple automations in Jira, and Slack to support Scrum practices. Familiarity with Github Actions is a plus.
• Strong communication skills grounded in commitment, courage, focus, openness, and respect. 

Qualifications: 

• Bachelor’s Degree in business, information technology, or 3 years’ work experience in related field required. 
• 3 years working in Scrum Master role or on a Scrum Team. 
• Certified Scrum Master (CSM) or equivalent certification preferred. 

Position Summary

The Provider Reimbursement and Contracting Leader is responsible for architecting and advancing network solutions that integrate network design, payment innovation and high-performing provider partnerships in a unified medical-pharmacy ecosystem.  This position will lead the development of differentiated network constructs, tailored ASO network solutions and high performing provider contracts with value‑based innovations that improve outcomes, optimize the total cost of care and enhance employer and member value.  Importantly, this role will align network and product design strategies to ensure overall utilization and costs are optimized.

This position will partner with senior leadership, product, IT, operational analytics teams to evolve the strategic direction and market differentiation of Judi Care, ensuring a unified, forward‑thinking approach that meets complex client needs, minimizing provider hassle and improving the member experience.  This leader will create the foundational methods, tools and processes for provider negotiation and lead a team to execute these contracts across the country. 

Position Responsibilities:

• Network Overall Optionality:  Work to contract with a range of network options to create client optionality, from large national PPO varieties  to specialty networks and tailored client constructs.
• Benchmarking, Analytical Tools and Processes:  Create a foundation of tools and repeatable processes that can be employed to evaluate and value network and contracting proposals.  This includes market and competitive analyses to identify opportunities for differentiation, innovation, and strategic growth across network, payment and provider performance domains.
• Reimbursement Methods:  Develop reimbursement methods that minimize provider abrasion and hassle while cultivating the right behaviors.   The leader should strive to develop method that are transparently comparable and can be adjudicated in a real-time, automated manner. 
• Value-Based Design:  Lead the development of value‑based payment models, performance frameworks, and incentive structures that improve outcomes, reduce total medical cost, and strengthen provider accountability.
• High‑Performing Provider Partnerships. Identify and cultivate contracted relationships with high-performing providers and strategic provider networks (e.g. direct primary care or oncology networks) to unlock new pathways for medical and pharmacy cost optimization, improved utilization and enhanced clinical outcomes. 
• Tailored ASO Networks and Geographic Micro Networks.  Select geographies based on provider and ASO concentration to enable direct contracting.  Build customized network solutions aligned to employer benefit design, cost‑of‑care goals, and market needs, ensuring differentiated value for self‑funded clients.  
• Product & Solution Integration.  Collaborate with product and analytics teams to embed network constructs, payment models, and provider insights into scalable, market‑ready offerings.
• Contracting Leadership.  Lead and mentor teams responsible for provider contracting, VBC program development, and network performance management, fostering a culture of innovation and operational excellence. Oversee negotiation and execution of provider contracts, ensuring alignment with strategic goals, regulatory requirements, and performance expectations.
• Responsible for adherence to the Capital Rx Code of Conduct.

Required Qualifications:

• MBA or related graduate degree preferred.
• 20+ years of experience in provider network design, VBC, and payment innovation within payer or provider organizations.
• Proven success developing ASO network solutions and partnering with high‑performing providers to reduce medical costs.
• Strong leadership, negotiation, and stakeholder engagement skills.
• Experience in fast‑paced, high‑growth or startup environments.

Position Summary:

As an individual contributor on the Product team, you will pay a critical role in contributing to the success of Capital Rx. The Capital Rx Product team seeks individuals who are passionate about improving the landscape of pharmacy prior authorizations, while providing superior service. The expectations for growth in this role are to push beyond the core data and reporting and to serve as an expert across all domains of Judi, our Enterprise Health Platform.

Position Responsibilities:

• Provide subject matter expertise support on Judi’s function and reporting capabilities related to prior authorization
• Take accountability for accurate translation of reporting requirements for Capital Rx’s customers 
• Support analytics and reporting needs for the prior authorization team and related groups
• Own swift resolution and clear communication of critical reporting issues
• Present analysis results clearly
• Assist in testing of new Judi functionality to ensure enhancements are functioning as expected and accurately processing claims transactions
• Build key cross-functional relationships with other internal teams
• Provide virtual and in person product demonstrations
• Note: Role may periodically require meeting participation, service support or other requirements outside of standard business hours

Minimum Qualifications:

• Bachelor’s degree, with record of strong academic performance in Computer Science, Actuarial Science, Statistics, or Economics or equivalent work experience strongly preferred
• 2+ years of proven experience in data analytics and reporting required
• 2+ years of experience in Structured Query Language (SQL) required
• 2+ years of experience with ETL or ELT preferred
• 2+ years of PBM, pharmacy, health plan, or related experience preferred
• 1+ years working with JSON or other data-exchange format tools preferred
• 1+ year of Python, R, or similar programming experience preferred
• Experience presenting analysis to clients and/or management preferred
• Proficient in Microsoft Excel
• Extremely organized, detail-oriented, and able to easily pivot priorities
• Ability to work effectively with virtual teams
• Ability to travel 5-10%

Position Summary

The Drug Pricing Surveillance Senior Analyst will play a key role in advancing Capital Rx’s pharmaceutical pricing strategy by collecting, analyzing, and interpreting market data across diverse reimbursement and distribution channels. This role partners closely with cross‑functional teams—including Analytics, Legal, Network Management, and Audit—to compare market pricing to Judi Health’s contracted rates, surface pricing variability, and identify opportunities for improved value for client plans and their members. The specialist will design integrated, user‑friendly reporting that enables data‑driven decision‑making and supports operational workflows across the organization. Additionally, this role contributes to safeguarding fiduciary responsibilities by helping stakeholders understand evolving industry dynamics and compliance expectations. The ideal candidate brings strong analytical skills, experience with pharmaceutical or healthcare data, exceptional communication abilities, and the capacity to manage multiple complex projects in a fast‑paced environment.

Position Responsibilities:

• Pharmaceutical Market Data Collection: Collect data on available prices to end users for pharmaceuticals across distribution and reimbursement channels, including traditional insurance reimbursement, direct-to-patient, and direct-to-employer models
• Pricing Comparison and Analytics: Use available reporting and analytics tools (and collaborate with our dedicated Analytics team) to compare available market pricing to Judi Health’s contracted pricing for pharmaceuticals; facilitate executive understanding of pricing variability
• Opportunity Analyses: Identify and investigate opportunities for pricing improvement, working with other teams and departments to scope initiatives aimed at achieving more favorable pricing for client plans and their members
• Integrated Report Design: Design and implement pricing variability data reporting for consumption by users across teams and levels that can be integrated into workflows of relevant teams (for example, audit, network management, etc.)
• Fiduciary Duty Protection: Use industry news and direction from our Legal team to facilitate understanding among key stakeholders of health plan sponsor fiduciary duty and our strategies to fulfill our responsibilities as dedicated administrators

Required Qualifications:

• Bachelor’s Degree required
• 2+ years of experience with significant data analytics responsibilities applicable to pharmaceutical pricing, such as in a health plan, PBM, value-based care, or managed care environment; consulting, advising, or tech enablement focused on the preceding areas also considered applicable
• Ability to balance multiple complex projects simultaneously with minimal direction
• Great time-management and organizational skills to manage multiple active projects simultaneously
• Exceptional written, verbal, and presentation skills
• Experience working with data reporting tools, conducting data analyses, and effectively consuming/interpreting data reports and visualizations
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
• Experience with programming languages relevant to data analytics, such as SQL or Python

Preferred Qualifications:

• Master’s Degree in relevant field (Management, Accounting, Healthcare Administration, Health Policy, Data Science, etc.)
• Experience with prescription drug channels and payment workflows (pharmacy reimbursement, rebate administration and GPO relations, regulatory requirements, etc.)
• Experience with health insurance or health benefits administration (pharmacy benefits in particular)
• Experience producing reporting that facilitates data-driven decisions and workflows for stakeholders across functions and levels
• Ability to think strategically and identify inefficiencies, develop long-term solutions, and challenge and improve existing processes through automation and redesign
• Highly detail-oriented and analytical
• Ability to travel occasionally as needed for internal, client, and vendor/partner meetings

Location: Remote (For Non-Local) or Hybrid (Local to New York, NY or Denver, CO area)

Position Summary

The Benefit Configuration Specialist is responsible for supporting the testing and validation of pharmacy benefit plan configurations across multiple lines of business, including Commercial, Medicaid, Exchange, and Medicare. This role ensures that benefit plan setups align with client intent, regulatory requirements, and internal configuration standards.The Specialist will execute comprehensive benefit testing, participate in pre-implementation audits, and validate plan accuracy prior to deployment. Responsibilities include reviewing plan design specifications, performing scenario-based testing, identifying configuration discrepancies, and collaborating with cross-functional teams to resolve issues. This position requires strong attention to detail, analytical thinking, and the ability to interpret complex pharmacy benefit structures. The ideal candidate is comfortable working in a fast-paced environment, managing multiple audits simultaneously, and communicating findings clearly to internal stakeholders.

Position Responsibilities:

• Execute end-to-end testing and validation of pharmacy benefit plan configurations across Commercial, Medicaid, Exchange, and Medicare lines of business.
• Perform detailed implementation audits to ensure benefit setup aligns with client intent, regulatory requirements, and internal configuration standards.
• Review and interpret plan design documents, benefit change forms, and formulary specifications to translate requirements into executable test scenarios.
• Analyze claim outputs to confirm expected adjudication behavior and accumulator movement.
• Identify, document, and communicate configuration discrepancies or defects; collaborate with configuration team to ensure timely resolution.
• Ensure compliance with applicable federal and state regulations, including guidance from the Centers for Medicare & Medicaid Services (CMS) where applicable.
• Maintain clear documentation of testing results, audit findings, and approval signoffs.
• Participate in client-facing meetings to review testing scope, discuss audit findings, clarify benefit intent, and provide detailed explanations of testing results and configuration outcomes.
• Partner with cross-functional teams to ensure benefit accuracy and successful implementation.
• Contribute to process improvements that enhance testing efficiency, audit quality, and overall benefit validation standards.
• Manage multiple audits and testing initiatives simultaneously in a deadline-driven environment.
• Responsible for adherence to the Capital Rx Code of Conduct

Required Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Information Systems, or related field (or equivalent work experience).
• Minimum 3–5 years of experience in pharmacy benefit management (PBM), health plan operations, or benefit configuration.
• Direct experience supporting Medicare lines of business (Medicare Part D and/or MAPD).
• Demonstrated understanding of Medicare benefit structures.
• Experience testing and validating pharmacy benefit configurations in Commercial, Medicaid, Exchange, and/or Medicare lines of business.
• Strong knowledge of formulary design, tier structures, utilization management (PA, ST, QL), and accumulator logic.
• Ability to analyze benefit design documents and translate requirements into executable test scenarios.
• Strong analytical skills with high attention to detail and accuracy.
• Proficiency in Microsoft Excel for data review, validation, and reporting.
• Strong written and verbal communication skills with ability to clearly document findings and discrepancies.
• Participate in client-facing discussions to review benefit testing outcomes and implementation readiness while providing clear guidance on complex benefit designs.

Base Salary:

• New York, NY (hybrid) $78,800 - $98,500
• Denver, CO (hybrid) $72,000 - $90,000
• Remote -  $62,400.00 - $90,000.00

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

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

Benefits

Judi Health provides all full-time and part-time benefit-eligible employees with the ability to elect medical and pharmacy coverage, dental insurance, vision insurance, accidental injury insurance, critical illness insurance, hospital indemnity insurance, and flexible spending accounts. Full-time employees also have access to a health savings account, voluntary life insurance, and voluntary accidental death and dismemberment insurance for themselves and their eligible dependents.

Judi Health provides full-time employees with the following benefits at no cost to the employee: basic life insurance, basic accidental death and dismemberment insurance, paid time off, sick time, holidays, short-term disability, long-term disability, an employee assistance program, and a wellness program. Full-time employees are also eligible for a 401(k) plan with company match after one year of full-time employment.

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.

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.

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

Position Summary 

The Learning & Development Lead – Technology is the dedicated learning partner for the Technology organization, focused on improving delivery effectiveness through capability building, consistent onboarding, and practical enablement resources. This role uses a consulting and business partnering approach to diagnose performance needs, design scalable learning and performance support, and partner with leaders to strengthen tech practices across teams. 

Position Responsibilities 

Consulting & Business Partnership 

• Serve as the primary L&D partner for Technology leaders and community; establish an intake rhythm and learning priorities aligned to delivery goals. 
• Conduct structured needs assessments (organization / role / task) to identify root causes behind development needs and recommend the right mix of solutions (not always training). 
• Build trusted partnerships and drive adoption through clear communication, stakeholder alignment, and shared accountability for outcomes. 

Agile Enablement & Practice Development (Scalable, Practical) 

• Design and deliver enablement that strengthens core concepts and shared language (e.g., MVP/MMF/MMP, iteration/incrementation, estimation and sizing practices). 
• Create reusable toolkits, job aids, and bite-sized learning assets that support on-the-job application. 
• Partner with technology leaders to embed reinforcement into operating cadences (retrospectives, team health checks, and delivery routines). 

Standardized Onboarding & Knowledge Base (Reducing Duplication) 

• Lead or support the centralization and refinement of Technology training materials to reduce duplicative documentation and improve onboarding consistency across teams. 
• Develop track-specific onboarding resources (how we deliver here, tools and norms, key workflows) to accelerate time-to-contribution. 

Program Design, Delivery & Facilitation 

• Own end-to-end design and delivery for an enablement portfolio (scope → design → pilot → launch → iterate), using strong project management and stakeholder communication. 
• Facilitate sessions directly and/or coordinate internal facilitators while maintaining quality and consistency across offerings. 

Measurement & Continuous Improvement (Impact Focus) 

• Define success measures and evaluation plans for key enablement efforts (reaction, learning, behavior/application; results where feasible). 
• Use participation, feedback, and adoption signals to improve programs and provide concise, executive-ready updates and recommendations. 
• Administer and maintain the learning management system (LMS) back-end for Technology enablement programs, including course setup, audience assignment/enrollment, completion tracking, and reporting dashboards to support measurement and compliance needs. 

Values-Based Enablement & Inclusive Practice 

• Embed inclusive learning and accessibility practices and reinforce consistent leadership and team behaviors through clear, practical enablement. 
• Support change enablement by providing communication-ready resources, job aids, and reinforcement guidance for leaders. 

Qualifications 

Required Education and Experience 

• Bachelor’s degree in Human Resources, Organizational Development, Education, Business, Psychology, or a related field (or equivalent experience). 
• 5+ years of progressive experience in Learning & Development, Talent Development, Organizational Development, or performance consulting. 
• Demonstrated capability in needs assessment, program design, facilitation, stakeholder partnership, and program/project management. 
• Experience partnering with technical or delivery organizations and translating complex practices into practical, usable enablement. 
• Experience administering a Learning Management System (LMS) and producing reliable participation/completion reporting to support program evaluation and stakeholder updates. 

Preferred Qualifications 

• Familiarity with learning measurement/evaluation approaches and using data to drive continuous improvement. 
• Relevant certifications (talent development, facilitation, coaching, evaluation, or change management). 

Knowledge, Skills, and Abilities 

• Consulting and business partnering skills; ability to diagnose needs and influence without authority. 
• Strong project/program management and stakeholder communication. 
• Excellent facilitation and learning design grounded in adult learning practices. 
• Ability to build reusable standards, toolkits, and knowledge resources that scale across teams. 
• Ability to use data and feedback to improve learning experiences and demonstrate impact. 

Position Summary:

As an individual contributor on the Product team, you will pay a critical role in contributing to the success of Capital Rx. The Capital Rx Product team seeks individuals who are passionate about improving the landscape of pharmacy prior authorizations, while providing superior service. The expectations for growth in this role are to push beyond the core data and reporting and to serve as an expert across all domains of Judi, our Enterprise Health Platform.

Position Responsibilities:

• Provide subject matter expertise support on Judi’s function and reporting capabilities related to prior authorization
• Take accountability for accurate translation of reporting requirements for Capital Rx’s customers 
• Support analytics and reporting needs for the prior authorization team and related groups
• Own swift resolution and clear communication of critical reporting issues
• Present analysis results clearly
• Assist in testing of new Judi functionality to ensure enhancements are functioning as expected and accurately processing claims transactions
• Build key cross-functional relationships with other internal teams
• Provide virtual and in person product demonstrations
• Note: Role may periodically require meeting participation, service support or other requirements outside of standard business hours

Minimum Qualifications:

• Bachelor’s degree, with record of strong academic performance in Computer Science, Actuarial Science, Statistics, or Economics or equivalent work experience strongly preferred
• 2+ years of proven experience in data analytics and reporting required
• 2+ years of experience in Structured Query Language (SQL) required
• 2+ years of experience with ETL or ELT preferred
• 2+ years of PBM, pharmacy, health plan, or related experience preferred
• 1+ years working with JSON or other data-exchange format tools preferred
• 1+ year of Python, R, or similar programming experience preferred
• Experience presenting analysis to clients and/or management preferred
• Proficient in Microsoft Excel
• Extremely organized, detail-oriented, and able to easily pivot priorities
• Ability to work effectively with virtual teams
• Ability to travel 5-10%

Location: Remote 

Position Summary: 

Our Scalability team as a Senior Scalability Engineer focused on observability platform development and engineering productivity. In this role, you will define, own, and build Judi Health's organization-wide observability strategy, tooling, and platform products. Beyond maintaining infrastructure, you'll architect and develop a custom observability platform that gives engineering teams powerful, fast, and cost-effective visibility into every layer of our infrastructure—from application logs and metrics to distributed traces. You'll build production-grade internal products using React/TypeScript frontends with Python and Rust backends, creating tools that fundamentally improve how engineers at Judi Health debug, monitor, and optimize their systems. Working closely with leadership and cross-functional teams, your work will be foundational to platform stability, performance optimization, and developer productivity across our rapidly growing healthcare platform. 

Position Responsibilities: 

In this role, you'll own the observability infrastructure that powers our engineering organization. You will:  

• Architect observability platform: Design, implement, and maintain the LGTM stack (Loki, Grafana, Tempo, Mimir/Prometheus) as the primary observability platform across all engineering teams, making architectural decisions that balance cost, performance, and developer experience.
• Build internal observability products: Design and develop production-grade internal platform products with React/TypeScript frontends and Python/Rust backends that provide engineers with powerful log search, metrics visualization, and trace analysis capabilities.
• Develop custom log indexing systems: Architect and build high-performance log indexing solutions using Rust that process logs and provide sub-second search across billions of log lines at a fraction of the cost.
• Integrate SQL analytics for logs: Design and implement solutions leveraging AWS Athena or similar SQL query engines (DuckDB, ClickHouse) for ad-hoc log analysis and historical queries, enabling engineers to run complex SQL queries over S3-based log data for deep investigations and trend analysis. 
• Create advanced query interfaces: Build sophisticated web interfaces that allow engineers to query logs, metrics, and traces with features like saved queries, query templates, correlation analysis, and pattern detection, supporting both full-text search and SQL-based analytics. 
• Balance cloud-native and open-source: Architect solutions that thoughtfully leverage both AWS-managed services (CloudWatch, Athena, Kinesis) and open-source tooling (LGTM stack, Quickwit) to optimize for cost, performance, and operational flexibility based on use case requirements. 
• Integrate AWS observability: Design seamless integration between AWS CloudWatch Logs/Metrics and our custom observability platform, providing unified visibility across managed and self-hosted infrastructure. 
• Build intelligent alerting: Develop smart dashboards, monitors, and alerting systems that reduce noise, detect anomalies, and help teams respond to incidents quickly. 
• Partner with engineering teams: Work directly with product teams to integrate observability into their services, establish logging and metrics standards, and instrument code effectively, serving as the observability subject matter expert. 
• Enable performance optimization: Provide the observability foundation that allows the Scalability team to identify performance bottlenecks, track optimization impact, and measure platform stability with data-driven insights. 
• Establish observability standards: Define and document comprehensive observability standards including structured logging patterns, metric naming conventions, trace instrumentation, dashboard design principles, and query best practices. 
• Drive platform adoption: Lead workshops, create documentation, and build self-service tooling that democratizes observability across engineering, making it easy for teams to adopt best practices. 
• Demonstrate technical leadership: Mentor engineers on observability practices, lead architecture reviews for instrumentation approaches, and represent the Scalability team in cross-functional planning. 
• Work in an Agile/Scrum environment to continually deliver value to stakeholders and clients. 
• Code of Conduct: Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. 

Required Qualifications: 

• 10+ years of software engineering or infrastructure engineering experience with demonstrated progression into technical leadership roles. 
• Several years of experience leading technical initiatives, building platform products, or serving as a subject matter expert on observability infrastructure. 
• Strong experience with React/TypeScript for frontend development and Python (Flask/SQLAlchemy) for backend services. 
• LGTM stack expertise: Deep production experience with Loki, Grafana, Tempo, and Prometheus/Mimir for logs, metrics, and distributed tracing at scale. 
• AWS observability: Extensive experience with AWS CloudWatch Logs and Metrics, including custom metrics, log insights, dashboard creation, and integration patterns. 
• SQL analytics for logs: Production experience with SQL-based log analytics using AWS Athena, DuckDB, or similar query engines for analyzing structured and semi-structured data at scale. 
• Cloud-native and open-source balance: Demonstrated ability to architect solutions leveraging both managed cloud services and open-source tooling, understanding trade-offs between operational overhead, cost, flexibility, and vendor lock-in. 
• Search and indexing experience: Hands-on experience building or operating search systems using OpenSearch, Elasticsearch, Lucene, Tantivy, or similar search and analytics engines. 
• Performance-critical systems: Experience building high-performance systems that process large volumes of data efficiently (millions of log lines, high-cardinality metrics). 
• Systems thinking: Deep understanding of distributed systems, microservices architectures, and the complex observability challenges they present. 
• Data at scale: Proven track record handling high-volume structured and unstructured logging data, identifying patterns, and building efficient search/query solutions that perform well under load. 
• Product mindset: Ability to build internal platform products that engineers love to use, with attention to UX, performance, and reliability. 

Preferred Qualifications: 

• Rust development experience: Production experience with Rust for building high-performance data processing, indexing, or search systems. Strong interest in learning Rust is acceptable if combined with systems programming experience in C/C++/Go. 
• Infrastructure as code: Experience with Terraform for managing observability infrastructure and AWS resources. 
• Additional observability platforms: Experience architecting or operating Datadog, New Relic, Splunk, or other enterprise observability platforms. 
• Advanced query languages: Deep expertise with PromQL, LogQL, SQL optimization, and query optimization for high-cardinality data. 
• Columnar storage formats: Experience with Parquet, ORC, or other columnar storage formats for efficient log storage and analytics on S3. 
• Incident management: Experience designing incident response workflows, postmortem processes, and SLO/SLI frameworks that drive reliability improvements. 
• Cost optimization: Track record of reducing observability costs while maintaining or improving capabilities (e.g., CloudWatch → S3/custom indexing migration). 
• Data pipelines: Experience with streaming data pipelines, ETL processes, or real-time data processing. 
• Distributed tracing: Deep knowledge of OpenTelemetry, Jaeger, Zipkin, or distributed tracing architectures. 
• Git expertise and experience working in a mono repository. 
• Previous Pharmacy Benefits Manager (PBM) or healthcare technology experience. 
• Experience building developer tools or internal platforms that improve engineering productivity. 

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. 

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