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Position Summary:
- Lead Utilization Management Pharmacist overseeing daily clinical pharmacy functions.
- Ensure efficient processing of medication requests while adhering to medical necessity and contractual criteria.
- Support and guide Utilization Management pharmacists to maintain high-quality performance.
Key Responsibilities:
- Perform prior authorization reviews, appeal reviews, and override requests.
- Collaborate with business and clinical partners to improve workflows and ensure consistency.
- Monitor queues to meet regulatory and internal compliance requirements.
Qualifications:
- Active, unrestricted pharmacist license and Doctor of Pharmacy or Bachelor's degree with 2+ years of experience.
- Experience in customer service, call center, and prior authorization.
- Ability to work independently in a remote, metric-driven environment.
Work Requirements:
- Must have a secure, quiet workspace and wired internet connection.
- Able to work 2p-11p ET shift with weekend and holiday rotation.
Judi Health
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. It replaces fragmented systems with a unified claims processing platform and uses AI-powered care delivery to serve millions of Americans, fostering a mission-driven, collaborative culture.