<div class="content-intro"><h2><strong>About Judi Health</strong></h2>
<p>Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.<br><br>At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering
benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit <span><a href="http://www.judi.health" target="_blank">www.judi.health</a></span>.</p></div><p><strong>Location:&nbsp;</strong> Hybrid (Local to Denver, CO, Charlotte, NC or NYC area)</p>
<p><strong><u>Position
Responsibilities:</u></strong></p>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Responsible for overseeing a group of prior authorization technicians and expanded responsibility for&nbsp;select&nbsp;administrative PA functions.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Work in conjunction with the pharmacy technician manager in analyzing available data and provide prior authorization staffing, workflow and system enhancement recommendations.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Support on-going training and coaching of u</span><span data-contrast="auto">tilization management</span><span data-contrast="auto"> pharmacy technicians.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Participate in the goal setting process and regularly review performance of direct reports, addressing performance and behavioral issues when needed.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Investigate/resolve escalated issues or problems from clients and providers.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Works with&nbsp;</span><span data-contrast="auto">utilization management</span><span data-contrast="auto">&nbsp;manager on other
responsibilities, projects,&nbsp;implementations&nbsp;and initiatives as needed.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Review pharmacy claims data for proactive outreach and intervention.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Maintain quality and productivity standards for all cases triaged while minimizing compliance risk.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Work with business and clinical partners as needed.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="4" data-aria-level="1"><span data-contrast="auto">Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="11" data-aria-level="1"><span data-contrast="auto">Proactively obtains clinical information from prescribers, referral coordinators, and&nbsp;appropriate staff&nbsp;to ensure all aspects of clinical guidelines are addressed for pharmacist review.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="11" data-aria-level="1"><span data-contrast="auto">Identify, document, and escalate provider concerns to the appropriate internal team including various members of the u</span><span data-contrast="auto">tilization management</span><span data-contrast="auto"> team.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions.</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Ability to work in a fast-paced environment with shifting priorities, and flexible schedules that may include weekends.</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="7" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="auto">Ability to work flexible schedules that includes an on-call weekend&nbsp;</span><span data-contrast="auto">and holiday&nbsp;</span><span data-contrast="auto">rotation.</span><span data-ccp-props="{}">&nbsp;</span></li>
</ul>
<p><span data-ccp-props="{}">&nbsp;</span></p>
<p><strong><u>Required
Qualifications:</u></strong></p>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Minimum 1 year of Prior Authorization and/or appeals experience</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Demonstrated ability to communicate effectively and manage team priorities</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="1" data-aria-level="1"><span data-contrast="auto">Strong organizational and problem-solving skills</span><span data-ccp-props="{}">&nbsp;</span></li>
<li data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required</li>
<li>Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint</li>
<li>Strong clinical background required</li>
<li>Excellent communication, writing, and organizational skills</li>
<li>Ability to multi-task and collaborate in a team with shifting priorities</li>
</ul>
<p>&nbsp;</p>
<p><strong><u>Preferred
Qualifications:</u></strong></p>
<ul>
<li>2+ years of leadership experience</li>
<li>Strong understanding of CMS regulations and payer
requirements</li>
<li>2+ years of PBM or Managed Care pharmacy experience&nbsp;</li>
</ul>
<p>&nbsp;</p><div class="content-pay-transparency"><div class="pay-input"><div class="title">New York, NY Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">&mdash;</span><span>$85,000 USD</span></div></div><div class="pay-input"><div class="title">Denver, CO Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">&mdash;</span><span>$85,000 USD</span></div></div><div class="pay-input"><div class="title">Charlotte, NC Salary Range</div><div class="pay-range"><span>$70,000</span><span class="divider">&mdash;</span><span>$85,000 USD</span></div></div></div><div class="content-conclusion"><p class="p1"><em>All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and
responsibilities as needed to best meet organizational goals.</em></p>
<p><em><span data-contrast="none">We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.</span></em><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">&nbsp;</span></p>
<p><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:0,&quot;335559739&quot;:0}">By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at<span class="Apple-converted-space">&nbsp;</span><a href="https://www.judi.health/legal/privacy-policy" data-outlook-id="be5f7242-36ad-42be-9caf-fd585904c3c5">https://www.judi.health/legal/privacy-policy</a>.</span></p></div>
About Judi Health
Judi Health is a health technology company providing a comprehensive suite of solutions for employers and health plans, including: - Capital Rx: a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers - Judi Health™: full-service health benefit management for employers, TPAs, and health plans - Judi®: a single, scalable SaaS solution that health plans can utilize to manage all their claim workflows Through these solutions, Judi Health is executing on its mission to give our country the infrastructure it needs for the healthcare we deserve.
