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Healthtech, Artificial Intelligence, Medical Imaging, Radiology

VP, Health Plan, Health System, & TPA Client Services

Charlotte, NCOnsiteFull Time$200,000–$275,000 /yrPosted 2 months ago

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Required skills

  • PBM
  • health plan
  • health system
  • TPA
  • payer administration
  • healthcare services
  • US healthcare delivery system
  • payer operations
  • provider networks
  • government programs

Nice to have

  • business
  • relevant professional experience

Role summary

Capital Rx is seeking a VP, Health Plan, Health System, & TPA Client Services to lead strategic growth, retention, and success for its client portfolio. This senior leadership role involves building executive client relationships, identifying growth opportunities, and resolving complex challenges. The VP will partner with Sales, Account Management, and various internal teams (Product, Operations, Clinical, Finance, Regulatory, etc.) to drive client outcomes and ensure successful delivery of commitments. Key responsibilities include leading executive discussions, managing cross-functional accountability, serving as an escalation point, and supporting highly regulated markets. The role requires a strong understanding of PBM economics, payer operations, and the US healthcare system, with a minimum of 10 years of leadership experience in the healthcare services environment.

About Judi Health

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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.

Location: Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)

Position Summary

The Vice President, Health Plan, Health System, & TPA Client Services serves as a senior leader responsible for the strategic growth, retention, and overall success of Judi Health's Health Plan, Health System, and TPA client portfolio. This individual partners with executive client stakeholders, account teams, and cross-functional leaders to drive client outcomes, identify growth opportunities, resolve complex business challenges, and ensure successful execution of client priorities. The role combines executive relationship management, business development, strategic planning, and operational leadership to support both client success and organizational growth.

Position Responsibilities:

  • Provide leadership support for Health Plan, Health System, and TPA relationships.
  • Develop and maintain senior-level client relationships.
  • Identify and advance growth, expansion, and retention opportunities.
  • Partner with Sales and Account Management on renewals and strategic opportunities.
  • Lead executive-level discussions regarding client strategy, performance, and long-term objectives.
  • Drive cross-functional accountability for client commitments and strategic initiatives.
  • Serve as an escalation point for complex operational, clinical, financial, and contractual issues.
  • Partner with Product, Operations, Clinical, Network, Finance, Regulatory, Compliance, Government Programs, and Implementation teams to execute client priorities, support delegated services, and ensure successful delivery of client commitments.
  • Partner with Underwriting, Supply Chain, Finance, and Account Management to support ongoing contractual needs, case financial optimization, savings opportunities, and strategies that improve client outcomes while supporting organizational growth.
  • Collaborate across the organization to assess, design, and implement client-specific programs, benefit administration requirements, operational partnerships, and other customized solutions needed to support Health Plan, Health System, and TPA clients.
  • Partner 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.
  • Assess organizational and client risks and develop mitigation strategies.
  • Coach and develop client-facing leaders and teams.
  • Support strategic planning and market-facing initiatives that strengthen Judi Rx's position within the Health Plan, Health System, and TPA market.
  • Required Qualifications:

  • Bachelor’s or advance degree in health administration, business, or relevant professional experience
  • 10+ years of leadership experience within PBM, health plan, healthcare services, payer administration, or related healthcare services environments.
  • Demonstrated success managing executive-level client relationships.
  • Experience leading complex accounts and multi-functional teams.
  • Experience supporting Regional Health Plans, Health Systems, TPAs, or payer organizations operating in highly regulated markets.
  • Strong understanding of the U.S. healthcare delivery system, payer operations, provider networks, government programs, and pharmacy benefit administration.
  • Strong understanding of PBM economics, rebate programs, formulary management, claims administration, and payer operations.
  • Experience partnering with Regulatory, Compliance, Government Programs, Underwriting, Supply Chain, Finance, Product, Operations, Clinical, Network, Technology, and Implementation teams to deliver client priorities.
  • Experience driving both revenue growth and client retention.
  • Strong executive presence and ability to influence stakeholders at all levels.
  • New York, NY Salary Range$200,000—$275,000 USDDenver, CO Salary Range$200,000—$275,000 USDCharlotte, NC Salary Range$200,000—$275,000 USD

    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 at https://www.judi.health/legal/privacy-policy.

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