What are the responsibilities and job description for the Manager, Financial Operations position at Capital Rx?
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. 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.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.
Position Description:
This Manager role is a critical position for Financial Operations and will be responsible for streamlining and executing invoicing for the following "non-standard" (non-PBM/PBA) lines of business: Capital Risk Management, Capital Equilibrium, Judi Care, Judi Group, Prime, and PIC. This role will partner internally and externally to ensure alignment on billing requirements and invoice specifications. This role will be an instrumental team player that will drive billing and reconciliation process improvement across all non-standard lines of business. The individual must have a strong financial background in PBM and be comfortable working with Excel and SQL formulas to efficiently run processes
Position Responsibilities:
- Billing Operations & Data Analysis
- Lead comprehensive billing processes by analyzing inbound data from multiple sources, including multi-year contracts, client programs, and service volumes (e.g., per claim, per member, one-time fees, recurring fees)
- Manage billing across various lines of business including commercial, public, private, and government health plans, covering drug spend and ancillary services
- Data Validation: Verify month-over-month data consistency across multiple sources
- Research discrepancies for root cause
- System Reconciliation: Reconcile billing records between internal platforms (e.g., ERP and adjudication systems) to ensure consistency
- Contract Review: Review internal documentation to confirm billable items are correctly captured
- Process Adherence: Follow established billing procedures and escalate discrepancies to senior finance staff
- Continuous Improvement & Collaboration with a focus on automation
- Utilize SQL or other data query applications to prepare journal entries, accruals, and adjustments as required
Required Qualifications:
- 2 years Health Care experience, inclusive of premium billing, self-funded, EGWP
- 2 years of related experience in finance, data analysis, or accounting
- Undergraduate bachelor's degree in Business, Finance, or quantitative field
- Strong Excel and SQL Skills
- Ability to challenge and improve existing processes through automation and redesign
- Motivated team player with the ability to work in a fast-paced, forward-moving environment
- Attention to detail & commitment to delivering high quality work
- Passion for healthcare and for driving lasting change in health and pharmacy benefits
- Ability to define problems, collect data, establish facts, solve problems, make recommendations, and draw valid conclusions in a timely and accurate manner
All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. 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.
We 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.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found athttps://www.judi.health/legal/privacy-policy.
Salary : $100,000 - $130,000