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Judi Health
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Open Positions
Collaborate with senior developers to implement new features and improve existing functionality. Write and test high-quality code based on design specifications and product requirements. Participate in planning and design discussions with product managers and designers.
Python
React
AWS
PostgreSQL
TypeScript
Establish and develop relationships with key client decision-makers to understand their healthcare strategy and goals. Oversee account management team with focus on client satisfaction, retention, and trend management. Analyze pharmacy claims data to identify clinical trends and provide actionable recommendations.
Pharmacy
Account Management
Microsoft Excel
Data Analysis
Communication
Ensures state and federal regulatory compliance for benefits and leave programs. Manages day-to-day benefits operations, including vendor management, employee support, and open enrollment. Conducts financial reviews and audits of benefits billing and data accuracy to ensure compliance and efficiency.
Benefits Administration
Microsoft Office Suite
Analytical Skills
Architect and advance network solutions integrating network design, payment innovation, and high-performing provider partnerships. Develop value-based payment models and tailored ASO network solutions to optimize total cost of care. Lead provider contract negotiation and mentor a team to execute contracts across the country.
Stakeholder Engagement
Design and configure prior authorization criteria, decision trees, and authorization parameters within the PA system. Perform quality assurance and quality control reviews to ensure clinical intent and regulatory compliance. Collaborate with internal teams and external clients to support delegated PA services and system optimization.
Clinical Pharmacy
Prior Authorization
Microsoft Excel
Quality Assurance
Efficiently triage incoming calls and resolve member and pharmacy issues with professional phone etiquette. Identify, document, and escalate concerns to appropriate internal teams to ensure quality care and safety standards. Support fraud, waste, and abuse programs by reviewing pharmacy claims and communicating findings to internal staff.
Customer Service
Call Center
Healthcare
Bilingual Spanish
Medicare
Act as the primary point of contact for incoming member calls, prior authorization inquiries, and ensure appropriate escalation of cases. Efficiently triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies with minimal support. Meet all departmental goals including schedule adherence, attendance, and quality monitoring.
Pharmacy Technician
Customer Service
Prior Authorization
CRM Systems
Microsoft Office Suite