Capital Rx

Sales

• Build and execute a national go-to-market plan to win net-new logos for the Judi platform
• Create pipeline through targeted outreach, your network, and disciplined account planning—then qualify opportunities quickly and honestly
• Run discovery that gets to the real buying drivers (configuration speed, flexibility, vendor consolidation, total cost) and maps stakeholders, timelines, and risks
• Lead product demos and storytelling that translate complex platform capabilities into clear business value for health plan/TPA executives and operators
• Own RFI/RFP strategy and responses in partnership with internal teams—ensuring submissions are accurate, compelling, and tailored to the prospect
• Manage commercial strategy end-to-end: scoping, pricing approach, security/compliance inputs, contract negotiation, and close
• Partner closely with Implementation and Product to set prospects up for successful delivery and long-term growth post-signature
• Maintain clean pipeline hygiene and forecasting in Salesforce, with clear next steps and executive-level updates
• Bring market feedback back to the business—what our prospects are asking for, competitive dynamics, and where we should invest to win more deals

VP, SaaS Sales

Client Services Representative

• Responsible for the overall satisfaction and retention of large enterprise employer commercial client(s) book of business
• Serve as the relationship owner on assigned book of business, incorporating internal support where and when as needed to foster relationships with C-suite, influencers, and decision makers at the plan
• Develop strategy plans, with support of clinical account consultant and account manager
• Support member and client satisfaction execution and net promoter score goals
• Provide deep and approachable plan recommendations with support of reporting and internal stakeholders
• Maintain thorough knowledge of contractual obligations assigned book of business, including financials, performance guarantees, terms, and regulatory/compliance
• Lead the account team in managing client vendor relationships as appropriate
• Lead client renewal process, including contract management
• Lead ownership of performance guarantee reporting and maintenance
• Lead regulatory and compliance components Interpret current pharmacy and healthcare trends, and meet with clients to provide proactive recommendations for plan management; find ways of adding value to the client curating offerings tailored to the client’s specific needs
• Identify and contribute to process improvement efforts across Capital Rx
• Assemble internal resources to overcomes challenges
• Anticipates customer needs and proactively identifies new opportunities within assigned accounts
• Develop a comprehensive knowledge of our business, including products and services. Strong ability to field questions from the client side, answer them and answer them correctly
• Review and advise on JUDI product roadmap to ensure current priorities and milestones will meet the client expectation

Account Executive, PBA Enterprise Client Services

Analyst

• Lead analytics projects, collaborating with business stakeholders to develop and deliver reporting solutions and actionable insights.
• Produce strategic insights on program performance, compliance, utilization trends, and financial projections.
• Ensure data integrity by developing and maintaining clear documentation of query logic, methodologies, and key assumptions.
• Work cross-functionally with internal teams to align analytical insights with business objectives, regulatory requirements, and financial considerations.
• Interpret current pharmacy and healthcare trends, and meet with clients to provide proactive recommendations for plan management; find ways of adding value to the client curating offerings tailored to the client’s specific needs.
• Apply expertise in data analytics to identify opportunities for process optimization, automation, and improved reporting methodologies.

Senior Analyst, Analytics – Business Insights

Pharmacist

• Evaluate and review all appeals requests to render coverage determinations based on clinical criteria and medical necessity.
• Perform and handle inbound and outbound phone calls with physicians, healthcare providers and/or patients to facilitate appeal requests, answer inquiries, and resolve escalations.
• Collaborate with internal and external Medical Directors by providing appropriate clinical/medical data needed to perform clinical reviews per the health plan criteria.
• Interpret clinical guideline criteria and appropriately utilize clinical knowledge and resources when rendering approvals and denials on all levels of appeals.
• Perform peer to peer reviews with providers when requested.
• Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.
• Provide detailed and thorough documentation in prior authorization cases, appeals cases, and overrides.
• Make clinical prior authorization determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
• 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.
• Deliver extraordinary customer care and service by responding to questions concerning customer accounts in a fast paced, structured environment within established time frames.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Appeals Pharmacist – Temp-to-Hire

Product Manager

• Collaborate with other PMs, engineers, UX designers, and other stakeholders to ensure on-time delivery of product features.
• Effectively manage and meet stakeholders’ priorities and expectations while assuming the role of a subject matter expert through deep intellectual curiosity and drive to learn.
• Partner with go-to-market and client-facing teams to identify key value-add opportunities.
• Drive the development of standardized and scalable data models.
• Analyze product data to derive insights to assist in the prioritization and post release optimization of the products.
• Translate business, analytics, and operational needs into a prioritized roadmap for the Enterprise Data Warehouse.
• Work with design team to conduct user experience testing and research.
• Collect and act on feedback from internal stakeholders and external clients to ideate and anticipate new products.
• Create and maintain team specific 15 month rolling product roadmap.
• Develop business requirements and specification documents.
• Perform backlog refinement, epic planning, and other scrum events.
• Conduct user testing prior to and post release of functionality to the customer.
• Publish value driven release notes and user guides.
• Present roadmap updates and product delivery risks to senior leadership.
• Manage and execute day-to-day project management functions with regards to the specific products under development.
• Support general business needs, as required.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Associate Product Manager

Artificial Intelligence

• Investigate the latest LLM MLM models and evaluate and compare accuracy and efficiency for our in-domain use cases
• Develop tools and processes to create data pipelines for ML training and customization
• Finetune LLMs for the healthcare domain
• Help develop and productionize machine learning (ML) solutions leveraging our customized models in the fields of Document understanding, Search and QnA, GenAI, Virtual Agents, etc.
• Work across the complete lifecycle of ML model development, including problem definition, data exploration, feature engineering, model training, validation, and deployment.
• Participate in code reviews, testing, and quality assurance processes.
• Troubleshoot and resolve technical issues related to AI model, integration, deployment and backend services.
• Document and communicate research and development processes, and architectural decisions.
• Ensure the security and compliance of healthcare data, adhering to HIPAA regulations.

Senior Applied AI/ML Scientist

IT Support

• Lead, mentor, and develop a team of IT Engineers
• Act as the final escalation point for complex IT Engineering and Helpdesk issues
• Own delivery of IT Engineering projects, including planning, prioritization, and resource allocation
• Drive implementation of strategic, systemic solutions to eliminate recurring issues and improve user experience
• Oversee administration and optimization of identity and access management (SSO), Endpoint management (MDM), and SaaS platforms (e.g., Office 365)
• Ensure onboarding and offboarding workflows are scalable, secure, and compliant
• Partner with Security, Engineering, and Business teams to define and enforce best practices and standards
• Evaluate, select, and deploy new technologies and software solutions
• Establish and maintain documentation, processes, and operational standards
• Manage cross-functional initiatives and coordinate with IT leadership on prioritization and resourcing
• Act as a liaison between IT Engineering and stakeholder teams
• Encourage automation and efficiency through scripting and process improvement
• Ensure appropriate support coverage, including participation in off-hours support as needed

IT Manager

Manager

• 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.
• 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

Utilization Manager, Appeals Technician

Medical Director

• Medical Director will complete assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients; governmental (Medicare/Medicaid) programs and individual client requested coverage determinations or appeals when appropriate
• Makes clinical determinations in accordance with medical necessity and criteria
• Performs scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to requesting prescribers
• Follow all internal procedures, job aids, and HIPPA guidelines to protect patient privacy and data security
• Support the Department’s responsibilities to provide peer-to-peer phone call support to physicians/prescribers who call the company with specific and general questions about our clinical programs, communications and utilization review decisions
• Communicates effectively and confidently with members to promote positive health outcomes
• Actively participates in the development of utilization management (PA) criteria and clinical policy revisions/reviews
• Ability to work in a fast-paced environment with shifting priorities
• Weekend on-call responsibilities (shared rotating call)
• Attention to detail and commitment to delivering high-quality work

Medical Director – Texas Licensed

Customer Success Manager

• Lead live product demos and facilitate trainings for clients during implementation and post-launch, ensuring stakeholders understand how to effectively use the platform.
• Translate product workflows and functionality into clear, engaging training sessions and documentation tailored to different client audiences.
• Create, maintain, and continuously improve documentation, including user guides, training decks, FAQs, and knowledge base content.
• Configure client-specific portals within Judi and support user acceptance testing (UAT) to ensure successful implementation and launch.
• Submit and track product enhancement and development requests, partnering closely with Product to communicate client needs, validate use cases, and support prioritization.
• Coordinate and track large-scale client migrations, including maintaining migration plans, status tracking, dependencies, timelines, and stakeholder communication.
• Serve as a primary point of contact for clients to triage questions, issues, and feedback, and provide 1/1 client go-live support.
• Partner closely with Product teams to stay current on roadmap priorities, feature changes, and workflows, and collaborate with the Implementation and Account Management teams to align on operational impacts and client needs.
• Act as a trusted Judi Care product expert in client meetings and cross-functional workstreams.
• Contribute to scalable implementation efforts by helping standardize training approaches, materials, and client-facing processes.
• Provide input into release readiness by assisting with testing, drafting release notes, and anticipating client training needs.
• Enable internal teams (Sales, Customer Success, Support) with Judi Care product knowledge and training resources as needed.

Customer Success Manager, Digital Tools

Security Engineer

• Lead, mentor, and scale a high-performing cloud security engineering function, fostering strong ownership, operational excellence, and continuous improvement.
• Own execution of the cloud security roadmap, prioritizing initiatives across FedRAMP readiness, zero trust architecture, cloud hardening, security automation, and continuous control validation.
• Define and evolve the cloud security strategy for Judi Health, aligning technical investments and security architecture decisions to business growth, regulatory commitments, platform resilience goals, and emerging AI initiatives.
• Serve as a trusted advisor to the CISO, engineering leaders, and executive stakeholders, helping drive secure-by-design decisions and modern security engineering practices across the organization.
• Lead the design, implementation, and continuous improvement of cloud security controls across AWS infrastructure, platforms, application environments, and supporting services.
• Identify, prioritize, and drive remediation of security risks across cloud services, infrastructure as code, third-party integrations, developer workflows, and enterprise platforms.
• Build and operationalize cloud security capabilities that support compliance with frameworks and customer obligations including FedRAMP, FISMA, SOC 2, HITRUST, HIPAA, and related control requirements.
• Drive threat detection, incident response readiness, vulnerability management, penetration testing, and security validation efforts to proactively identify and reduce risk.
• Advance automation for security monitoring, alerting, evidence collection, and policy enforcement to improve scalability and support continuous compliance.
• Establish meaningful security metrics and reporting for cloud posture, control effectiveness, and roadmap progress, and communicate insights clearly to senior leadership.
• Partner with software engineering, platform engineering, DevOps, IT, and AI teams to embed security into architecture, infrastructure, the software development lifecycle, and AI-enabled capabilities.
• Work closely with compliance, legal, privacy, and risk management teams to translate regulatory and customer requirements into practical, auditable technical controls.
• Lead technical engagement for third-party assessments, customer security reviews, and external audits, ensuring strong preparation, evidence readiness, and timely remediation.
• Help define and operationalize a modern security framework for AI initiatives, including governance, data protection, access controls, third-party risk, and secure adoption practices.

Director, Cloud Security

Software Engineer

• 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.
• 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.
• 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.
• 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.

Tableau Developer

Full-stack Engineer

• Collaborate with senior developers to implement new features and improve existing functionality.
• Combine technical leadership with hands-on coding to build scalable, high-impact healthcare technology.

Full Stack Software Developer

Business Analyst

• Intake product requests from operations stakeholders and clients.
• Triage, research and identify technical solutions for data errors occurring within the Judi Health tech stack.
• Work with operations and implementation teams to manage issue prioritization and resolution.
• Collaborate with the APM to build business requirements and specifications for road mapped items as directed by the APM.
• Responsible for ticket review and identification of misintent post QA.
• Identify and make data driven recommendations to APM for high value product enhancements.
• Assist product team with user experience testing, research, documentation, and stakeholder communication.
• Partner with APM to manage backlog and participate in team refinement & planning.
• Provide support to the APM and team in terms of planning, roadmap development, and long-term strategy.
• Responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance.

• Ensures state and federal regulatory compliance filings and government regulations, ensuring benefits and leave programs adhere to applicable laws.
• Performs regular financial reviews of benefit carrier billing to ensure the accuracy of invoices and enrollment compared to change files, vendor systems, inputs, and payroll.
• Provide day-to-day benefits support, assisting employees in navigating their benefits needs.
• Ensures the accuracy of all benefits enrollments in the HRIS to provide vendors with accurate eligibility information.
• Leads new-hire orientation benefit sessions.
• Performs quality checks of benefits-related data.
• Understands self-insured benefits plans and stop loss.
• Manage, review, validate and process life status changes.
• Serve as point of contact for benefits inquiries from employees on plan provisions, benefits enrollments, status changes and other general questions.
• Oversees leave-of-absence and disability requests.
• Effectively interprets FMLA, ADA and state leave implications as they relate to leaves of absences/disabilities.
• Manages the open enrollment process.
• Provides necessary reports for allocation/billing charges.
• Document and maintain administrative procedures for assigned benefits processes.
• Prepares special reports by collecting, analyzing and summarizing information and trends.
• Maintain up to date materials for benefits vendors on company intranet.
• Assist with the maintenance and testing of the HRIS and other systems and with benefits and wellness initiatives.
• Conduct regular audits to ensure the accuracy and completeness of benefits data, making necessary corrections and updates.
• Stay informed about changes in benefit trends, laws and regulations, ensuring ongoing compliance and timely adjustments to policies.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.