Vice President – Health Plan - Health System, & TPA Client Services
About the job
- A bachelor's or advanced degree in health administration, business, or relevant professional experience.
- At least 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 multifunctional 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.
- 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.
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