Client Operations Manager

Capital Rx

New York City, NY, US
  • Job Type: Full-Time
  • Function: Technical/Customer Support
  • Post Date: 04/02/2021
  • Website: [email protected]
  • Company Address: 85 Broad Street, New York, NY, 10004

About Capital Rx

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Through its Clearinghouse Modelâ„ , Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Job Description

About Capital Rx:

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 Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change.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

Position Responsibilities:

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

Qualifications / Profile:

    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
    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

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.

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Disclaimer: Local Candidates Only
This company does NOT accept candidates from outside recruiting firms. Agency contacts are not welcome.