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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.
Position Summary
The Senior Manager, Client Experience & Risk Optimization exists to lead risk-based operational initiatives from intake through execution, ensuring client-impacting issues, audits, and performance guarantee (PG) commitments are captured consistently, assigned clear ownership, structured into actionable workstreams, and tracked to resolution. Reporting into Risk Management leadership, the Manager builds and owns the operating model that integrates risk management, project execution, analytics, and process improvement across the Audit, PG, and CERO functions. The Manager directly leads a team of Analysts, partners cross-functionally with Legal, Compliance, Finance, Client Services, and Technology, and delivers the reporting and analysis leadership needs to understand emerging risks, recurring issues, workload trends, and opportunities for operational improvement.
Position Responsibilities:
Team Leadership & Development
- Directly manage, coach, and develop the Audit, PG, and CERO Analysts.
- Establish performance expectations, priorities, and development plans for team members.
- Oversee workload management, resource allocation, and operational execution across all assigned functions.
- Foster a culture of accountability, collaboration, continuous improvement, and operational excellence.
Operational Governance & Execution
- Lead intake, triage, prioritization, tracking, and resolution processes across Audit, PG, and CERO functions.
- Ensure workflows are standardized, documented, scalable, and consistently executed.
- Maintain SOPs, process documentation, governance standards, and operational controls.
- Coordinate cross-functional activities and manage escalations impacting operational performance or risk.
Project & Initiative Management
- Structure risk-based initiatives into project plans with defined scope, milestones, owners, and timelines.
- Organize and execute cross-functional workstreams, coordinating resources and dependencies from intake through completion.
- Manage changes to initiative scope and evaluate progress, developing mitigation plans when timelines or deliverables are at risk.
- Facilitate working sessions and apply consistent project and governance methodology across the team.
Reporting, Analytics & Operational Visibility
- Lead development of operational reporting, dashboards, KPIs, and analytics that provide visibility into audit readiness, PG performance, intake trends, operational risks, and overall organizational performance.
- Partner with Analytics and Technology teams to automate reporting processes, improve data visibility, and reduce manual effort.
- Analyze trends, recurring issues, operational bottlenecks, and emerging risks to support proactive decision-making.
- Provide leadership with actionable insights, reporting, and recommendations based on data and performance indicators.
Process Optimization & Continuous Improvement
- Identify opportunities to streamline workflows, automate processes, and improve operational effectiveness.
- Lead continuous improvement initiatives utilizing data, stakeholder feedback, and root-cause analysis.
- Drive implementation of process enhancements that improve efficiency, quality, and scalability.
- Support development of operational frameworks that strengthen organizational readiness and reduce risk.
Cross-Functional Partnership & Risk Support
- Partner with Risk Management leadership to support audit readiness, regulatory compliance, and performance guarantee oversight.
- Collaborate with Legal, Compliance, Finance, Client Services, and Technology teams to address operational challenges and risk-related activities.
- Support strategic initiatives requiring operational coordination, reporting, and execution.
- Escalate significant risks, trends, and operational concerns to leadership as appropriate.
Required Qualifications:
Education & Experience
- Bachelor's degree required
- 5+ years of operations, analytics, risk, or process improvement experience
- 2+ years of leadership experience
Technical & Analytical Skills
- Dashboard and KPI development
- Reporting and analytics experience
- Process improvement and automation experience
- Advanced Excel proficiency
Leadership & Communication
- Cross-functional stakeholder management
- Team development and coaching
- Ability to manage competing priorities
Preferred Qualifications
- Experience in healthcare, PBM, health plan, payer, audit, compliance, or risk management environments.
- Experience with Power BI, Tableau, SQL, or similar analytical and reporting tools.
- Knowledge of performance guarantees, contract governance, audit management, or operational risk programs.
- Experience building reporting and operational performance frameworks from the ground up.
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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