Jess Favorite
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Jess Favorite Email & Phone Number

Customer Success Manager - Benefit Administration |Capital Rx (PBM) at Capital Rx
Location: Sahuarita, Arizona, United States 3 work roles
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Role
Customer Success Manager - Benefit Administration |Capital Rx (PBM)
Location
Sahuarita, Arizona, United States
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Jess Favorite is listed as Customer Success Manager - Benefit Administration |Capital Rx (PBM) at Capital Rx, a company with 118 employees, based in Sahuarita, Arizona, United States. AeroLeads shows a matched LinkedIn profile for Jess Favorite.

Jess Favorite previously worked as Customer Success Manager - Benefits Administration at Capital Rx and Senior Pharmacy Program Manager at Optum.

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Capital Rx

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Profile bio

About Jess Favorite

In my role as Customer Success Manager at Capital Rx, it is my responsibility to oversee the benefits translation of our client’s various complex plan setups into our innovative platform, JUDI. Working directly with the client to ensure all benefits are translated from older, outdated systems into our cloud-native health adjudication platform with a 100% customer satisfaction in our method of implementation and claims outcomes. Previously, as a Sr. Program Manager at Optum, I led and oversaw multiple complex and strategic projects that deliver innovative solutions for specialty pharmacy, benefits administration, and pharmacy benefit management. With over six years of experience in this role, I have successfully managed large-scale initiatives that improve customer satisfaction, operational efficiency, and quality outcomes. Some of my achievements at Optum include launching a new automated platform for benefits implementation, implementing a regulatory requirements for PBMs and Pharmacies, and facilitating cross-functional collaboration among internal and external stakeholders. I also developed and refined my skills in project management, communication, problem-solving, and analytics, as well as my domain expertise in healthcare and pharmacy. I am passionate about making pharmacy healthcare more accessible, affordable, and effective for everyone, and I strive to deliver excellence and innovation in everything I do.

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Capital Rx
Capital Rx
Customer Success Manager - Benefit Administration |Capital Rx (PBM)
new york, new york, united states
Website
Employees
118
AeroLeads page
3 roles

Jess Favorite work experience

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Customer Success Manager - Benefits Administration

Current
  • Provide configuration services and support of Capital Rx’s Software as a Service (SaaS) customers for migration and ongoing use of JUDI.
  • Provide customers with subject matter expertise in JUDI’s capabilities, ensuring successful migration to the adjudication platform, with parity of all plan benefit logic and initiatives.
  • Accountable for accurate translation of requirements/setup of plan benefits from previous adjudication systems and configure to the customer’s intent.
  • Build and maintain trusting relationships with customers through superior customer service, meeting or exceeded service level metrics.
  • Lead communications throughout the implementation period by providing detailed and strategic guidance on plan benefit configuration, including intersection points with network, formulary, clinical and data exchanges.
  • Proactively identify execution risks that would inhibit successful launch in JUDI or negatively impact member experience and propose mitigation strategies.
Jun 2024 - Present

Senior Pharmacy Program Manager

  • Project management for complex and extensive specialty pharmacy projects related to new and improved pharmacy and PBM products, regulatory compliance, financial aid programs.
  • Develop and implement strategic programs to optimize specialty pharmacy benefits and processes for improved patient outcomes and cost savings, increasing cost-saving programs for members, program value for clients.
  • Lead efforts to identify initiatives to increase specialty pharmacy script capture rate for all specialty therapeutic classes, increasing pharmacy program cost effectiveness and member experience in the high-cost drug.
  • Track federal and state regulatory changes to ensure compliance within client benefit restrictions and pharmacy/PBM practices.
  • Resolve complex member claim inquiries and group benefit implementation issues including reviews for complaints filed with the Department of Insurance and via VIP submissions from client liaisons and account managers.
  • Lead educational training sessions on innovative programs/products and knowledge transferring discussions regularly to new and seasoned employees to improve understanding of how each program impacts member and client.
Feb 2017 - May 2024

Lead Benefit Configuration Analyst

  • Collaborated with Account Management to implement plan structure for pharmacy benefit plans within RxCLAIM/AS400 and other various IT platforms across the business. As a Lead configuration analyst this included complex.
  • Performed an array of claim testing to ensure proper claim adjudication and benefit setups for clients. Created testing models to streamline thorough testing.
  • Worked on an Internal Quality Review team and led coaching sessions to assist with complicated benefit builds.
  • Participated in project management forums as Benefits Operations Management SME to code new products and programs for clients to meet customization requests or regulatory requirements.
  • Heavy focus on attention to detail and time management, meeting deadlines while maintaining high quality especially during benefit implementation peak season. Constructed and upkept an automated benefit configuration.
Aug 2012 - Feb 2017
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FAQ

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What company does Jess Favorite work for?

Jess Favorite works for Capital Rx.

What is Jess Favorite's role at Capital Rx?

Jess Favorite is listed as Customer Success Manager - Benefit Administration |Capital Rx (PBM) at Capital Rx.

Where is Jess Favorite based?

Jess Favorite is based in Sahuarita, Arizona, United States while working with Capital Rx.

What companies has Jess Favorite worked for?

Jess Favorite has worked for Capital Rx and Optum.

Who are Jess Favorite's colleagues at Capital Rx?

Jess Favorite's colleagues at Capital Rx include Mark Pearce, Faith Achenbach, Cpc, Ahfi, Punita Repe, Andrea Lovell, and Simir Cooper.

How can I contact Jess Favorite?

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