Capital Rx

QA Engineer

• Identify, investigate, and triage technical issues within the JUDI tech stack.
• Monitor and analyze system logs to validate application functionality, identify performance bottlenecks, and detect anomalies.
• Utilize SQL to query and analyze data within the JUDI database.
• Collaborate with the engineering team on the support and monitoring of AWS services utilized within the JUDI platform.
• Collaborate with Product Managers and engineers to understand business requirements and translate them into actionable test requirements and test plans.
• Conduct thorough QA tasks, including ticket review, refinement, testing, and bug identification.
• Partner with the scrum team to manage backlogs, refine tickets, and support roadmap development.
• Assist with UAT testing, stakeholder communication, and documentation to align team efforts with business goals.
• Ensure adherence to company policies, including timely reporting of noncompliance.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Technical QA Analyst II

Product Designer

• 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.

UX/UI Designer

Analyst

• Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols
• Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data
• Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols
• Serving as a point of coordination for member eligibility issue identification and issue resolution with internal teams and external partners
• Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data
• Proactively monitoring system status and eligibility data to quickly identify potential abnormalities that might impact quality and accuracy
• Ensuring that all issues and errors are resolved using designated operating standards and within defined service levels
• Assist with the validation of eligibility data integrity through regular audits and reconciliation processes
• Ensure accurate and timely entry of group/plan structure determinations for benefits and enrollment

Data Exchange Analyst

Operations

• Work with Data Exchange partners and internal teams to develop and maintain Data Exchange data feeds (ex. claims, vaccine reimbursements, eligibility, etc.) and ensure their accuracy at Capital Rx
• Serving as a point of coordination for Data Exchange identification and issue resolution with internal teams and external integration partners
• Identify and triage Data Exchange issues and support the resolution of all errors related to transferring, loading, and management of integrated Data Exchange data
• Proactively monitoring system status and Data Exchange management data to quickly identify potential abnormalities that might impact quality and accuracy
• Ensuring that all issues and errors are resolved using designated operating standards and within defined service levels
• Assist with the validation of Data Exchange data integrity through regular audits and reconciliation processes
• Participate in projects with Data Exchange impacts including vendor changes, client migrations, and client add-on requests

Analyst, Data Exchange – Claims Operations

• Analyze complex datasets to identify trends, outliers, and opportunities for operational improvement across Medicare, Medicaid, and Exchange programs
• Develop and maintain recurring and ad-hoc reports, dashboards, and analytical tools to support data-driven decision-making
• Create and maintain a repository of standardized code templates to streamline report generation and automate routine tasks
• Ensure analytical outputs align with regulatory requirements and business objectives by interpreting CMS and state guidance in partnership with internal subject matter experts
• Support the development of scalable processes that enhance efficiency, accuracy, and responsiveness across government program operations
• Design and implement automated solutions to reduce manual effort and improve process scalability and accuracy
• Implements and uses analytical software to support the department in achieving goals as defined by executive leadership
• Facilitate requirements gathering sessions to understand business needs and translate them into actionable analytical deliverables
• Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met
• Presents and communicates complex analytical findings in a clear and concise manner
• Participates in user acceptance, and quality assurance testing of new application features and team deliverables
• Supports root-cause-analysis and reporting of encounter data issues/errors by partnering with key stakeholders – Will also provide operationally support
• Prepares high-level user documentation and training materials as needed
• Work with internal and external clients to research, develop, and document new standards to enhance reporting capabilities
• Collaborate with cross-functional teams—including compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations—to refine and enhance operational capabilities
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Senior Analyst – Analysis & Efficiencies

Business Analyst

• Monitors for changes in existing business processes and updates documentation accordingly - Finds new opportunities for process developments and improvements
• Intake, analyze and manage requests from stakeholders
• Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team
• Drives root-cause-analysis and resolution of data and processes issues/errors by partnering with key stakeholders
• Supports analytical, problem-solving functions by defining and documenting specifications pertinent to all departmental processes
• Analyzes business workflow and system needs for conversions and migrations to ensure that government submissions, recovery, and cost savings regulations are met
• Prepares end user documentation and training materials as needed
• Support government data submission processes by analyzing complex data issues using data from internal and external sources
• Improve government data submission processes by reviewing and synthesizing state and federal recourses, consolidating into comprehensive business requirements documents
• Support creation of intake request to enhance existing processes by gathering requirements and level setting with stakeholders on required processes
• Develop and set up performance metrics for stakeholder distribution
• Performs root cause analysis of government data processing and submission issues; develops recommendations based on data and industry knowledge

Senior Business Analyst, Government Programs Operations, Claims & Encounters

Account Manager

• 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.

Account Manager, PBM

• Supervise and support a team of Clinical Account Managers, Account Managers and Account Coordinators, to ensure client satisfaction, retention, and performance.
• Support clients in a leadership capacity, focusing on escalation management and relationship development.
• Manage market segment client book.
• Conduct regular team meetings to align goals, share updates, and address challenges.
• Mentor and develop team members to enhance their skills and knowledge in PBM services.
• Handle escalations and provide strategic guidance to resolve client issues efficiently.
• Serve as the point of contact for key clients, fostering strong, long-term relationships.
• Lead team in the form of clinical account managers, account managers and account coordinators to ensure proactive and effective communication with clients.
• Support implementation teams with client onboarding, ensuring a smooth transition and clear understanding of PBM services.
• Proactively address client concerns, ensuring quick and effective resolution of issues.
• Act as a liaison between clients and internal teams to manage escalations and resolve conflicts.
• Stay updated on industry trends and regulations, sharing knowledge with the team
• Implement process enhancements to optimize service delivery and efficiency.
• Help build and develop job aids, policies and procedures, and standard operating procedures for the client account management team.
• Responsible for adherence to the Capital Rx Code of Conduct

Associate Director, Clinical Account Manager

Manager

• Design and implement interactive voice response (IVR) workflows that improve the call experience
• Partner with customer facing contact center teams to develop technical solutions
• Develop and deploy contact center technical standards across virtual call center globally
• Identify opportunities to leverage existing technology solutions and new technical solutions to improve customer, client, provider and agent experiences
• Design and document technical solutions, including architectural documents, engineering design documents and operational documentation
• Serve as an IVR escalation point
• Develop standard operating procedures for support of technical solutions
• Ensure adequate system capacity to support business growth projections
• Oversee all IVR projects from inception to implementation and post cut-over support
• Responsible for overall design, expansion, and enhancements of IVRs and call flows
• Design and deploy new applications with other IT systems integration for other products
• Develop applications that can retrieve data using various data sources and data types through internal ingestion systems
• Collaborate across stakeholders including IT, Engineering, Product, and Vendor resources to successfully deliver projects
• Use experience designing and deploying complex contact center solutions leveraging InContact CXOne platforms and technologies
• Use InContact Studio, IEX, Thin Agent, MAX Agent, and DID configuration
• Use Central, CXOne, and InContact's reporting and analytics tools
• Use ability to integrate InContact platforms with other technology
• Use voice-centric programming languages and industry standard call recording platforms
• Design solutions that balance both customer's needs and aligns to IT's technology roadmap
• Use understanding of supporting and troubleshooting complex, global VOIP deployments including SBCs, SIP trunking and multiple carriers

Senior Manager, Telecom Analytics, Reporting

Customer Success Manager

• Build and maintain trusting relationships with clients through superior customer service. Provide oversight of the clients ongoing use of Judi.
• Accountable for accurate and timely transition of new clients into the Judi platform.
• Lead communications throughout the implementation process, including, but not limited to, detailed and strategic guidance for benefit builds, accumulations feeds, network build, and complex claim situations/requests.
• Proactively identify execution risks and mitigation strategies.
• Provide ongoing client support to troubleshooting inquiries.
• Understand and manage requests for new features in alignment with the product roadmap.
• Partner with product managers and directors operating in an agile framework to conceptualize and break down functional and non-functional requirements needed to be the market leading offering within Judi.
• Identify and drive efficiencies to increase rate of adoption in market.
• Provide virtual and in person product demonstrations to prospective clients with the ability to sell product differentiators and resonate with current operational challenges.
• Certain times of year may require meeting participation, service support or other requirements outside of standard business hours, including weekends.
• Responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance.

Customer Success Consultant

• Champion the use of DBT, GitHub, and modern data stack tools to improve code quality, reproducibility, and collaboration.
• Support the adoption of analytics best practices and tools through training sessions and knowledge sharing.
• Serve as a senior individual contributor on the Analytics team, setting technical standards and mentoring other analysts.
• Design and maintain modular, scalable data models in DBT to support reporting and analysis.
• Build and maintain self-service analytics tools using Tableau, with exposure to Streamlit.
• Identify areas for improving efficiency through process improvements, automation, and better data practices.
• Maintain documentation of key analytics processes and ensure data quality standards are upheld.
• Conduct data modeling and analysis to generate insights that inform business strategy and process improvements.
• Translate complex analytical findings into clear, actionable recommendations using visualizations and presentations.
• Contribute to proactive analytics that support operational and strategic decision-making.
• Partner with product managers, business leaders, and clients to understand analytics needs and prioritize requests accordingly.
• Proactively manage and foster stakeholder relationships by acting as a strategic, consultative advisor with a keen understanding of business objectives.
• Advocate for data-driven decision-making across teams and leadership.
• Ensure adherence to company compliance standards, including reporting any noncompliance.
• Support the development and implementation of quality controls and departmental standards to satisfy organizational and regulatory requirements.
• Participate in internal training sessions to support continued learning and development.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Senior Analyst, Analytics – Corporate Reporting

Project Manager

• Manage one large, complex project with multiple communication channels or several smaller projects simultaneously.
• Define and maintain project scope, objectives, and deliverables by translating business, clinical, or technical requirements into actionable plans that operate within Capital Rx’s existing agile framework.
• Work closely with internal subject matter experts as well as cross functional parties from sales, operations, compliance, product, scrum team, and others to identify project needs
• Interact daily with product manager and scrum teams with effective and efficient communications to ensure proper tracking of project roadmap and hold all project team members accountable for accurate and timely completion of assigned tasks.
• Maintain open and consistent communication with all stakeholders through regular status updates and feedback loops.
• Identify, track and report project progress, risks and if necessary, present a mitigation plan to leadership and stakeholders during weekly status meeting and other internal meetings.
• Establish and manage project tracking systems and tools (e.g., Jira) to support agile workflows and task execution.
• Ensure project deliverables meet quality standards, compliance requirements, and stakeholder expectations.

Proposal Manager

• Lead RFP/RFI responses for Judi Health and Capital Rx prospects, covering medical and pharmacy components.
• Develop and scale bid-management processes for medical administration/health benefits proposals.
• Partner with enterprise content management and marketing teams to keep shared materials current, compelling, and competitive. This individual will assume ownership of the Judi Health and Judi Care sections of the content database.
• Manage project plans, timelines, and resources to meet RFP requirements and ensure timely, complete submissions.
• Customize proposal content based on regulatory guidelines, client demographics, utilization insights, and benefit design
• Provide training and mentorship on proposal development best practices to subject matter experts and the proposal team, as it relates to the assigned market(s).
• Streamline workflows through templates, automation, and tooling enhancements.
• Uphold the Capital Rx/Judi Health Code of Conduct and report any noncompliance.

Proposal Development Manager

• 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.

Proposal Development Analyst

Attorney

• Draft and negotiate a variety of legal documents for day-to-day operations
• Conduct legal diligence for any target company to identify potential legal risks, liabilities, and other issues that could impact the deal.
• Provide strategic advice to the General Counsel and the Company, on the most beneficial structure for a transaction, considering business goals, tax implications, and corporate governance.
• Ensure all transactions comply with relevant laws and regulations, which can include securities, antitrust, and foreign investment laws.
• Manage the end-to-end legal aspects of a transaction, deal, or strategic business relationships, serving as the central point of contact for all parties involved and overseeing the entire process through to closing.