Source Job

Oversee a team of pharmacy technicians in the prior authorization process. Analyze data and provide recommendations to maximize team agility and performance. Generate and deliver reports on technician metrics to stakeholders.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans.

• 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.

Judi Health provides 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 scalable, secure platform.

• Review clinical documentation to determine medical necessity and program compliance.
• Decide on authorization or denial of prior approval requests via telephone.
• Provide pharmaceutical expertise to advisory board’s clinical workgroups.

UMass Chan Medical School welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.

• Support the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs.
• Manage a team of 8 pharmacists through a remote setting, overseeing a countrywide prior authorization program specific to workers compensation claims.
• Monitor, analyze, and trend clinical program data to assist in the development, implementation, and driving of key initiatives.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected.

• Lead, coach, and develop Team Leads and Member Services Associates.
• Own performance outcomes for medication access including resolution time, pharmacy turnaround, quality scores, and member satisfaction.
• Serve as the primary operational partner for pharmacy vendors, owning escalation patterns, performance issues, and workflow alignment.

Maven is the world's largest virtual clinic for women and families with a mission to make healthcare work for all. They have raised more than $425 million in funding and have been recognized as a Time 100 Most Influential Company and a Fast Company Most Innovative Company.