Provider Relations Specialist

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.

Location: Remote (For Non-Local) or Hybrid (Local to NYC area or Denver)

Position Summary:

The Provider Relations Specialist serves as a key liaison between the Capital Rx and its pharmacy network providers. This role is responsible for managing provider relationships, maintaining contract integrity, resolving pharmacy inquiries, and supporting network operations. The specialist ensures smooth communication and operational efficiency across all stakeholders.

Position Responsibilities:

• Manage the account for a designated group of pharmacy providers including chain pharmacies and independent pharmacies which shall include:
  • serving as the day-to-day contact for an assigned group of pharmacy providers,
  • answering relevant emails and phone calls,
  • executing pharmacy network reporting requests, and
  • escalating issues as needed to the Manager.
• Manage applicable contract routing and dissemination, standard contract and amendment creation, and maintain and update the contract databases.
• Manage the ongoing/consistent outreach to pharmacy providers as necessary to finalize contracts to ensure the department is executing on its goals to close out the agreements.
• Manage the communication of pertinent information such as drug recalls and payer sheet information to pharmacies.
• Act as the first point of contact for the call center help desk regarding pharmacy contractual issues and escalate the issues as needed to the Manager.
• Works closely with the Manager, Provider Relations to execute on the departmental and organizational goals.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Minimum Qualifications:

• Bachelor’s degree.
• 2 yrs of PBM experience in provider/network relations, contracting or other relevant experience.
• Strong communication and project management skills with the ability to develop effective working relationships with providers and internal and external stakeholders.
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.
• Highly organized and self-directed with minimal supervision required.

Preferred Qualifications:

• Certification in pharmacy technician or related field is a plus.

All employees are responsible for adherence to the Capital Rx 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.

JUDIHealth 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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