About Capital Rx
Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.
Location: Remote (U.S)
Position Responsibilities:
- Lead, develop, mentor and grow the team responsible for rebate payments, reporting, and client reconciliations
- Set priorities, manage workloads, and ensure the team meets key business objectives
- Lead continued development, maintenance and monitoring of rebate reporting and reconciliation models
- Coordinate with cross-functional teams to ensure rebate reporting is accurately produced and maintained
- Lead function responsible for identifying potential rebate reconciliation/contracting variances and drive timely resolution of variances
- Utilize SQL queries and/or Python to manage, automate, and improve efficiencies of structured and unstructured data
- Collaborate with other business functions (clinical, underwriting, finance, legal) to design, refine, and maintain internal reporting, modeling, and SOPs
- Develop KPI metrics and reporting to track progress on efficiency gains, issue resolution and successful mitigation of financial exposure
- Establish and document SOPs to ensure accurate reporting and payment quality and reliability
- Be an advocate for best practices and continued learning
- Support general business needs and ad-hoc analysis, as required
- Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
Required Qualifications:
- Undergraduate bachelor’s degree, with record of strong academic performance in Accounting, Finance, Actuarial Science, Statistics, Economics, Mathematics, or Business Administration
- 6+ years of proven experience in financial analysis, actuarial services, accounting, pricing and underwriting, network pricing, or pricing operations
- Prior PBM experience highly preferred
- The ideal candidate will understand pharmacy rebate dynamics with a focus on accuracy and attention to detail
- Experience working with structured and unstructured data
- Highly analytical; demonstrable knowledge of SQL, Excel, or other data visualization tools (Python or R experience preferred though not required)
- Track record of leading cross-functional initiatives, driving high performance, meeting deadlines and executing on deliverables
- Strong attention to detail with an intellectual and professional curiosity
- Ability to balance multiple complex projects simultaneously
- Exceptional written and verbal communication skills
- Extremely flexible, highly organized, and able to easily shift priorities
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.
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.
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