$75,000–$87,000/yr
- Direct and execute day-to-day pricing and underwriting.
- Collaborate with various team to refine financial models.
- Present final underwriting to leadership, articulating potential risk.
Judi Health
9 open remote positions
Judi Health is an enterprise health technology company providing solutions for employers and health plans. The company provides a comprehensive suite of solutions and is working with clients to rebuild trust in healthcare.
Salary Distribution 9 of 9 jobs
$28
Min
$87,000
25th
$130,000
Median
$145,000
75th
$320,000
Max
Benefits Overview 1 of 9 jobs
diverse workplace
(1)
Open Positions
$75,000–$87,000/yr
- Support RFP/RFI opportunities for new and renewal PBM opportunities with low to moderate complexity.
- Support the creation and maintenance of consultant templates for assigned channel partners.
- Create and refine SOPs to support RFP response development and submission working in collaboration with proposal managers and directors.
$250,000–$320,000/yr
- Draft and negotiate legal documents for day-to-day operations and company transactions.
- Conduct legal due diligence to identify potential legal risks and liabilities.
- Ensure all transactions comply with relevant laws and regulations.
$90,000–$140,000/yr
- Drive the sales strategy for Capital Rx’s suite of clinical programs end-to-end.
- Proactively assess client data to identify opportunities and deliver compelling presentations.
- Cultivate and manage trusted relationships with pharmacy benefit consultant groups.
$80,000–$90,000/yr
- Collect, clean, process, and analyze potential and current clients’ pharmaceutical data using SQL, R, Python, and MS Excel.
- Thoroughly understand internal and external data fields, identify patterns of data irregularities, and improve data quality and intake.
- Assist in the writing and maintenance of the Underwriting infrastructure code in SQL, R, and Python.
$24–$28/hr
- Research end user issues independently, when needed, and document/develop a solution per company standards
- Identify MDM related company needs and create, configure, test and deploy management of user systems via MDM Software.
- Responsible for all onboarding and offboarding related IT activities, including system-wide access, purchasing and retrieving of equipment, upgrades, asset tagging, etc.
$120,000–$130,000/yr
- Evaluate and review all appeals requests to render coverage determinations based on clinical criteria and medical necessity.
- Perform scientific literature evaluation using primary, secondary, and tertiary drug resources to support decision-making and recommendations to providers.
- Make clinical prior authorization determinations in accordance with medical necessity and covered benefit guidelines within established turnaround times.
$160,000–$170,000/yr
- Lead and oversee Prior Authorization Operations across all lines of business.
- Manage Prior Authorization processes ensuring optimal efficiency and compliance.
- Drive cross-functional collaboration to align with organizational goals.
$135,000–$145,000/yr
- Complete monthly utilization management and appeals performance and process audits.
- Present audit results to leadership to address issues.
- Assist management in identifying, evaluating, and mitigating risks.