Utilization Management Pharmacist Trainer Capital Rx LLCUtilization Management Pharmacist TrainerNew York, NY$135,000–$145,000 / yearBy delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. As a pharmacist Trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our pharmacist staff.
Formulary Operations Specialist Capital Rx LLCFormulary Operations SpecialistNew York, NY$70,000–$85,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi 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. Uploads formulary composites in the adjudication platform and supports Benefits team testing by uploading adjudication data to applicable Salesforce cases.
NewVP, Health Plan, Health System, & TPA Client Services Capital Rx LLCVP, Health Plan, Health System, & TPA Client ServicesNew York, NY$200,000–$300,000 / yearPartner with Regulatory, Compliance, Government Programs, and operational leaders to monitor and support highly regulated Health Plan markets, including State DOI and HHS/CMS requirements across Medicare, Medicaid, Exchange, insured, and FHBP business, as well as services delegated to Judi Health. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
Staff Software Engineer, Caching Capital Rx LLCStaff Software Engineer, CachingNew York, NY$200,800–$251,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi 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. Deep understanding of cache consistency and the failure modes that emerge at scale, such as thundering herd, hot key saturation, cache leasing, and dual-write consistency problems, and the judgment to choose the right invalidation strategy for a given workload.
Account Manager, PBM Capital Rx LLCAccount Manager, PBMNew York, NY$100,400–$125,500 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi 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. Position Summary: The Account Manager, PBM is responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations.
AI Solution Architect TechDigital CorporationAI Solution ArchitectHolmdel, NJSolution & Enterprise Architecture Deep expertise in solution architecture disciplines: capability modelling, application architecture, integration architecture, data architecture, and security architecture. Technology Stack (Hands-On Proficiency) Java / J2EE: Java 11–21, Spring Boot, Spring Framework, Jakarta EE, microservices with REST/gRPC, Apache Kafka, JPA/Hibernate, PostgreSQL, Oracle.
Pharmacist in Charge PIC ICARE PHARMACY PLUSPharmacist in Charge PICMorris Plains, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. - Balanced Schedule: Maintain a healthy work-life balance with our balanced work schedules.
PART TIME PHARMACIST ICARE PHARMACY PLUSPART TIME PHARMACISTPaterson, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. Job Description: Icare Pharmacy Plus is seeking a dedicated and highly skilled Pharmacist to join our team.
PHARMACIST IN CHARGE ICARE PHARMACY PLUSPHARMACIST IN CHARGEPaterson, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. Job Description: Icare Pharmacy Plus is seeking a dedicated and highly skilled Pharmacist to join our team.
NewAccount Manager-Trucking The Third GroupAccount Manager-TruckingManalapan, NJThe ideal candidate will have a strong background in account management with a focus on serving clients within the trucking and transportation sector. Overview: We are seeking an experienced Account Manager specializing in the trucking industry to join our team.
Field Service Agent - Queens - Bilingual Mandarin/Cantonese HealthfirstField Service Agent - Queens - Bilingual Mandarin/CantoneseQueens, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
Field Service Agent - Queens - Bilingual Spanish HealthfirstField Service Agent - Queens - Bilingual SpanishQueens, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
Private Client Account Executive Personal Risk Management SolutionsPrivate Client Account ExecutiveNew York, NY$90,000–$110,000 / yearAs a Private Client Account Executive, you will be responsible for a variety of client focused tasks and will be an integral part of a team who services our client accounts, ensuring customer satisfaction throughout the process. This role is essential in providing comprehensive support to clients, ensuring a high level of customer service and is an integral part of our service team, which is well known for being among the best in the business.
Field Service Agent - Bilingual Spanish - Manhattan HealthfirstField Service Agent - Bilingual Spanish - ManhattanManhattan, NY$48,600–$65,960 / yearInitiate investigations, partner with other assigned parties to participate in root cause analysis, communicate complex information, take proactive and/or corrective measures and/or recommend solutions and methods for process improvement and follow-up on outstanding customer inquiries and complaints within defined timeframes. Manage face-to-face encounters by interacting with customers to provide information in response to inquiries about products and services, improve overall member experience, and reduce waiting time to expedite traffic flow.
Field Service Agent - Manhattan - Bilingual Spanish HealthfirstField Service Agent - Manhattan - Bilingual SpanishManhattan, NY$48,600–$65,960 / yearThis individual receives and addresses member & provider inquiries, de-escalates and resolves complaints, educates clients, engages in member retention activities, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within a face-to-face, telephonic, and/or Omni-channel contact center environment. The Field Service Agent maintains the Healthfirst culture and drives improvements to ensure the best possible customer experience as measured by First Encounter Resolution and Customer Experience measures for our "North Star" Members and the Providers who service them.
CCO Service Agent - 100% Remote HealthfirstCCO Service Agent - 100% RemoteNYRemote$40,200–$54,570 / yearThis individual receives and addresses member & provider inquiries, resolves complaints, educates clients, retains members, helps to prevent dis-enrollments, and escalates issues requiring additional intervention across all Lines of Business (LOBs) within our traditional and/or Omni-channel contact center environment. Initiates investigations as required, partnering with other assigned parties to participate in root cause analysis, takes proactive and/or corrective measures and/or recommends solutions and methods for process improvement and follow-up on outstanding customer inquiries and complaints within defined timeframe.
Lead, Medical Network Pricer Capital Rx LLCLead, Medical Network PricerNew York, NY$128,000–$160,000 / yearApply Medicare-based pricing, Reference-Based Pricing (RBP), fee schedules, resource-based relative value methodologies, diagnosis-related groups, ambulatory payment classifications, per-diem rates, case rates, percent-of-charge arrangements, stop-loss provisions, and other approved reimbursement approaches. Advanced knowledge of procedure, revenue, diagnosis, and modifier logic; physician fee schedules; resource-based relative value methodologies; diagnosis-related groups; ambulatory payment classifications; per-diem, case-rate, percent-of-charge, and other medical reimbursement arrangements.
Vice President, Marketing & GTM Insurance SaaS Evolution IQVice President, Marketing & GTM Insurance SaaSNew York, NY$260,000–$275,000 / yearAs part of CCC Intelligent Solutions, a publicly traded technology company (NASDAQ: CCC) serving the P&C insurance industry, we combine EIQ''s AI-native product development with CCC''s 40 years of proprietary data and deep carrier relationships. About Us: EvolutionIQ''s mission is to deliver state-of-the-art technology that helps insurance claims teams make claims handling more accurate, fair, and efficient, so that more people impacted by injury or illness can continue their lives with dignity and stability.
Customer Care Specialist SaiaCustomer Care SpecialistLong Island, New YorkRead, write, communicate and comprehend the English language in order to perform the various tasks of the job, including but not limited to: converse with co-workers and members of the general public, including customers; understand oral and written instructions as well as governmental regulations; respond to questions and inquiries from management and government representatives; and accurately complete various documents, reports and records required of the position. Delivers escalated support to customers while working closely with terminal operations to resolve disputes, scheduling conflicts, and service concerns.
Staff Product Manager, Claims Experience Coalition IncStaff Product Manager, Claims ExperienceNYAs a Staff Product Manager for our Claims Experience, you will own the systems and workflows at the heart of that promise: making our claims handling faster, smarter, and more effective for the internal teams who run it and the brokers and policyholders who depend on it. Develop and maintain a clear product strategy and roadmap for Coalition''s claims experience, with a strong emphasis on operational efficiency spanning workflow tools, automation, ML-powered insights, and customer-facing experiences.