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Judi Health

Unified claims processing for health benefits

Account Executive - Pharmacy Benefit Management

Full-Time
$136.4k - $190k
Mid
Bachelor's
Charlotte, NC, USA+2 moreMore locations: New York, NY, USA | Denver, CO, USA
HybridThree days on-site per week required.
Sales & Account ManagementAccount Management

About the job

Requirements
  • A bachelor's degree in health administration, business, or a related field, or equivalent relevant professional experience.
  • At least 3 years of experience in healthcare, pharmacy benefits, or account management supporting commercial clients; candidates with deeper experience may be considered for more complex account assignments.
  • Demonstrated ability to lead client relationships and operate confidently in client-facing settings.
  • Strong business acumen and ability to connect data, market dynamics, and client goals into a cohesive strategy.
  • Experience navigating or supporting renewal cycles, contract discussions, and competitive retention strategies.
  • Ability to manage multiple priorities and deadlines effectively.
  • Proficiency in Microsoft Office and industry-related software programs; strong Excel and data interpretation skills are preferred.
  • Ability to travel up to 25%, depending on business needs and seasonality.
Responsibilities
  • Serve as the primary relationship lead for an assigned book of business, building trusted stakeholder relationships and leading account strategy, plans, and recommendations aligned to client goals, benefit philosophy, and business objectives.
  • Lead the broader account team by coordinating internal partners and clarifying roles, priorities, deliverables, and client commitments.
  • Drive a high-quality client experience through proactive account leadership, risk identification, issue resolution, and retention-focused execution.
  • Lead client-facing interactions, including stewardship meetings, quarterly business reviews, renewals, and strategic issue resolution; independence and stakeholder seniority scale with experience.
  • Translate reporting, trend data, market insights, and operational performance into clear, actionable recommendations and client-specific narratives.
  • Own the renewal process for assigned accounts, including strategic positioning, internal alignment, and competitive defense.
  • Support client implementations, including strategically reviewing plan design documents to ensure plan design reflects client intent, supporting pre- and post-go-live testing and claims review, handling escalations, and ensuring a successful handoff to client services.
  • Support contracts during the sales process and manage transitional ownership through the client lifecycle.
  • Support member and client satisfaction execution and net promoter score goals.
  • Lead regulatory and compliance components.
  • Identify and pursue cross-sell and upsell opportunities for ancillary services and products to expand accounts and deepen client value.
  • Maintain knowledge of contractual obligations, financial terms, performance guarantees, cost drivers, and reporting and compliance requirements across the assigned book of business, and lead related client discussions as needed.
  • Partner with underwriting, analytics, and finance teams to align commercial commitments with operational execution.
  • Partner with Clinical Account Consultants and other subject-matter experts to integrate clinical strategy into broader client narratives and recommendations.
  • Maintain working knowledge of Judi Health products, services, and strategic priorities to answer client questions accurately and position solutions effectively.
  • Review and advise on product and service enhancements, including JUDI-related priorities, to align evolving capabilities with client expectations and market needs.
  • Support prospective sales initiatives, including capability presentations and finalist support, both live and virtually.
  • Identify and contribute to process improvements that enhance consistency, scalability, and the overall client experience.
  • Perform other duties as assigned.
Desired Qualifications
  • Experience supporting large, complex employer, labor, or public sector clients.
  • Experience leading cross-functional teams in a matrixed environment.
  • Ability to tell a compelling story using data, trends, and performance insights, with strong executive presence.
  • Understanding of client-level financial dynamics, including pricing structures, performance guarantees, and profitability drivers.
  • Experience mentoring or coaching others and helping improve overall team effectiveness.
  • Project management experience.

About the company

Judi Health is a health technology and benefits administrator that serves employers, unions, health plans, and government entities through three brands: Judi Rx (transparent pass-through PBM with flat fees), Judi Care (medical, dental, and vision benefit administration and care navigation), and Judi Cloud (licenses the platform to plans and TPAs). Its core product is Judi, a Unified Claims Processing platform that brings pharmacy and medical benefits and medical, dental, and vision claims onto a single cloud system with AI-enhanced workflows. This approach replaces fragmented legacy systems by offering end-to-end benefits administration on one platform, differentiating itself with price transparency and a non-opaque fee structure. The goal is to simplify and lower the cost of health benefits administration while scaling across commercial, Medicare, and Medicaid markets and expanding access through licensing and care navigation.

Company Size

501-1,000

Company Stage

Series F

Total Funding

$585M

Headquarters

New York City, New York

Founded

2017

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Simplify's Take

What believers are saying

  • September 3, 2026 adds Color Health, WellTheory, and Cylinder to clinical ecosystem.
  • August 11, 2026 Inc. 5000 ranking signals five straight years of growth.
  • January 12, 2026 surpassed five million contracted PBM lives and 80 partnerships.

What critics are saying

  • St. Luke’s-related fraud suit from 2023 persists, exposing contract and misrepresentation risk.
  • CVS’s non-compete litigation shows talent and IP disputes with incumbents remain live.
  • If unified claims adoption stalls, Judi becomes another niche PBM against CVS/Cigna.

What makes Judi Health unique

  • Judi Health’s July 15, 2026 Unified Claims Processing merges pharmacy, medical, dental, vision.
  • September 8, 2026 StarkRx with Employers Health offers modular cost-plus PBM flexibility.
  • July 30, 2026 FedRAMP Ready status differentiates Judi for federal healthcare buyers.

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Benefits

  • Health Insurance
  • Remote Work Options
  • Hybrid Work Options
  • Wellness Program
  • Mental Health Support
  • Conference Attendance Budget
  • Professional Development Budget

Growth & Insights and Company News

6 month growth

0%

1 year growth

0%

2 year growth

4%
Business Wire
Oct 20th, 2026
Judi Health launches Judi Rx Retire, a CMS-approved Medicare Part D plan for employer groups

Judi Health, a health technology company and benefits administrator, has launched Judi Rx Retire, a Medicare Part D plan for employer groups and their Medicare-eligible retirees. The Centers for Medicare & Medicaid Services (CMS) approved it as an Employer Group Waiver Plan (PDP-EGWP). The plan runs on Judi Health's Judi platform and offers transparent pricing, flexible coverage, and technology-enabled administration. Employers can access claims data, cut out third-party middlemen, and verify the full value of the CMS subsidy. "Retirees are often an afterthought in a healthcare system that continues to defy logic and reward complexity over clarity," said chief executive officer AJ Loiacono. Judi Rx Retire holds the CMS contract directly and keeps eligibility, claims, and formulary data in one system. Its member care team promises 24/7/365 support, with 97% first-call resolution.

Associated Press
Sep 8th, 2026
Employers Health and Judi Health launch StarkRx transparent PBM solution for self-funded plans

Employers Health has launched StarkRx, a transparent pharmacy benefit solution developed with Judi Health. The cost-plus model aims to give self-funded plan sponsors greater visibility into pharmacy costs and more control over their benefit plans. StarkRx offers flexible plan designs backed by Judi Health's technology platform. Features include a broad retail pharmacy network using cost-plus reimbursement, a specialty pharmacy network including Amazon and Accredo by Evernorth, and integration with third-party solution providers. The offering allows Employers Health's 500-plus clients, covering 2.5 million lives and nearly $6.1 billion in spend, to work collaboratively whilst avoiding restrictions associated with traditional spread models. Chris Goff, Employers Health's CEO, said the platform enables clients to identify market innovators and implement solutions more quickly.

HIT Consultant
Jul 15th, 2026
Capital Rx rebrands as Judi Health, raises $400M to unify pharmacy, medical, dental and vision claims

Capital Rx has rebranded as Judi Health following a $400 million funding round. The transparent pharmacy benefit manager is expanding beyond prescription drugs to launch Unified Claims Processing, consolidating pharmacy, medical, vision, and dental benefits on a single cloud platform called Judi. The company has achieved 20,000% organic enrolment growth over five years, now serving over 50 million individuals across commercial, Medicare, and Medicaid segments. Judi Health operates through three divisions: Judi Rx (pass-through pharmacy benefit model), Judi Care (medical benefit administration), and Judi Cloud (platform licensing for health plans). A June 2026 survey by Employee Benefit News found that 100% of transparent pharmacy benefit manager adopters would choose the pass-through framework again, with most migrating from traditional incumbents.

Associated Press
Jul 15th, 2026
Capital Rx rebrands to Judi Rx after $400M funding, launches medical benefits and cloud licensing arms

Judi Health has rebranded its pharmacy benefit manager Capital Rx to Judi Rx and launched two new divisions: Judi Care for medical benefit administration and Judi Cloud for platform licensing. The announcement follows a $400 million financing round. Founded in 2017, the company has grown its contracted lives by 20,000% over five years to more than 50 million across commercial, Medicare, and Medicaid. A June 2026 survey found transparent PBMs are now expected to dominate the industry over the next three to five years. The company's proprietary Judi platform consolidates pharmacy and medical benefit administration on a single system. Judi Care handles medical, dental, and vision solutions, whilst Judi Cloud enables health plans and third-party administrators to license the technology.

Business Wire
Feb 12th, 2026
Judi Health names John Nicolosi as CAO following $400M funding round

Judi Health has appointed John Nicolosi as Chief Administrative Officer to lead its newly established Administrative Services function. Nicolosi will oversee client-facing operations including implementation, client services, customer care and government programmes. Nicolosi brings over 20 years of healthcare and pharmacy benefit management experience, with a track record in driving organisational growth and client satisfaction. He previously held multiple leadership roles overseeing large-scale implementations and clinical strategy. The appointment follows Judi Health's significant expansion, including over 80 new partnerships, a $400 million funding round, and the launch of its unified pharmacy and medical claims adjudication platform. Nicolosi holds a Doctor of Pharmacy degree from Midwestern University and a bachelor's degree from the University of Illinois.