Capital Rx

Account Manager

Capital Rx

full-time

Posted on:

Location Type: Hybrid

Location: Colorado, New York • 🇺🇸 United States

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Salary

💰 $80,000 - $100,000 per year

Job Level

JuniorMid-Level

Tech Stack

SQL

About the role

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

Requirements

  • Bachelor’s Degree preferred, or equivalent combination of education, training, and experience
  • 2+ years of proven experience in PBM / health plan, benefits consulting, or healthcare
  • Health Plan experience required
  • 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
  • Medicaid experience required
  • 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
Benefits
  • Health insurance
  • Retirement plans
  • Paid time off
  • Flexible work arrangements

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
SQLdata analysisquality assuranceclaims processingsystem configurationproject managementdocumentationbenefit managementdata integrationhealthcare compliance
Soft skills
communicationrelationship buildingcross-functional collaborationorganizational skillsflexibilityattention to detailproblem-solvingtime managementleadershipadaptability
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