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Judi Health
Judi Health
10 open remote positions
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They offer full-service health benefit management solutions, and consolidate all claim administration-related workflows in one secure platform.
Salary Distribution
10 of 10 jobs
Benefits Overview
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Open Positions
Prepare complex prior authorization requests by identifying clinical guidelines for review. Proactively obtain clinical information from prescribers to ensure all aspects of clinical guidelines are addressed. Effectively use problem solving skills to identify gaps and resolve concerns.
Communication
Writing
Organizational Skills
Problem Solving
Project Management
Accountable for configuration, load, and maintenance of data. Provide customers with subject matter expertise in Judi’s capabilities. Devise a repeatable process for implementing data in Judi.
SQL
JSON
Java
R
Excel
Support RFP/RFI opportunities for new and renewal PBM opportunities. Create and refine SOPs to support RFP response development and submission. Demonstrate mastery of products, services, and financial model to complete assignments.
Proposal Writing
Project Management
Microsoft Office
Adobe
Healthcare
Execute end-to-end testing and validation of pharmacy benefit plan configurations. Perform detailed implementation audits to ensure benefit setup aligns with client intent and regulations. Analyze claim outputs to confirm expected adjudication behavior and accumulator movement.
PBM
Excel
Medicare
Medicaid
Efficiently triage incoming phone calls with professional phone etiquette. Provide support for call center staff and resolve issues promptly. Effectively communicate issues and solutions to members and pharmacies.
Customer Service
Call Center
Communication
HIPAA
PBM
Provide subject matter expertise support on Judi’s function and reporting capabilities related to prior authorization Take accountability for accurate translation of reporting requirements for Capital Rx’s customers Support analytics and reporting needs for the prior authorization team and related groups
SQL
JSON
Python
R
Excel
Act as the primary point of contact for incoming member calls and prior authorization inquiries. Accurately advise callers on options for exception requests based on client benefit elections. Efficiently triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies.
Customer Service
Pharmacy
Prior Authorization
Call Center
Communication
Lead and nurture a dynamic team of clinical pharmacists and technicians. Create and uphold robust policies and procedures for utilization management review. Generate and deliver comprehensive reports on prior authorization metrics.
Leadership
Microsoft Office
Communication
Prior Authorization
Support intake, review and tracking of client services issues. Create and maintain process documentation and workflow maps. Identify manual processes and propose improvement opportunities.
Documentation
Organization
Spreadsheets
Communication
Review, analyze, and reconcile pharmacy claims and payments data. Configure vendors for payment processing in our financial system. Ensure accurate and timely processing of pharmacy, member, and provider payments and remittances.
SQL
Excel
Data Validation
Analytical
Communication