Senior Manager Government Program Operations
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About Us: Judi Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; Judi Health, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and Judi, the industry's leading proprietary Enterprise Health Platform. To learn more, visit www.judi.health. Position Summary: The Senior Manager, Government Programs Operations - Medicare is responsible for ensuring accurate adjudication of Medicare Part D prescription drug claims while maintaining compliance with CMS regulations. The ideal candidate will have extensive knowledge of Medicare Part D claims processing rules, regulatory changes to claim adjudication requirements, and industry best practice standards. Position Responsibilities: Claims Adjudication and analysis:
Regulatory Compliance & Quality Assurance:
Process Improvement and System Support:
Leadership:
Minimum Qualifications:
Salary Range
$120,000
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$135,000 USD This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. 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. |