About the role
<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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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><span style="text-decoration: underline;">Location:</span></strong> Hybrid (at least 3 days per week in our NYC, Denver, or Charlotte offices)</p> <p><span style="text-decoration: underline;"><strong><span data-contrast="auto"><span data-ccp-parastyle="Normal (Web)">Position Summary</span><span data-ccp-parastyle="Normal (Web)">:</span></span></strong><span data-ccp-props="{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;201341983&quot;:2,&quot;335557856&quot;:16777215,&quot;335559738&quot;:0,&quot;335559739&quot;:240,&quot;335559740&quot;:240}">&nbsp;</span></span></p> <p><span data-contrast="none">The Provider Relations Specialist provides essential credentialing review and management to support the Judi Rx networks of pharmacies. This work involves deciding whether pharmacies meeting Judi Rx’s credentialing
requirements allowing for inclusion in the Judi Rx pharmacy networks and maintaining the information related to credentialing. The ideal candidate will have experience in credentialing providers, managing reporting requests, and contribute to scalable solutions to streamline processes.</span> <span data-ccp-props="{&quot;335557856&quot;:16777215,&quot;335559739&quot;:240}">&nbsp;</span></p> <p><em><span style="text-decoration: underline;"><span data-ccp-props="{&quot;335557856&quot;:16777215,&quot;335559739&quot;:240}">Six-month temporary engagement with possible conversion to full-time.</span></span></em></p> <p><strong><u>Position
Responsibilities:</u></strong></p> <ul> <li>Manage credentialing for applicable pharmacies for inclusion in the provider networks and maintain the information related to credentialing so that Judi Rx has the most relevant information available. This includes getting applicable licenses and certificates of insurance from pharmacies as well as verifying eligibility in the NCPDP database and federal and state websites (e.g. OIG, GSA, SAM).</li> <li>Ensure the applicable pharmacies are valid by reviewing exclusion lists on an ongoing basis to identify any excluded pharmacies and referring those pharmacies to the appropriate team members/departments for removal.</li> <li>Manage the development and maintenance of a credentialing database to ensure proper tracking of all relevant credentialing information.</li> <li>Manage credentialing reporting requests working with the appropriate internal teams.</li> <li>Manage gathering and tracking annual pharmacy required attestations to ensure compliance with contractual and accreditation
requirements.</li> <li>Develop applicable credentialing policies and procedures.</li> <li>Gather pertinent information from pharmacies regarding services offered and opportunities and provide direct contracting support to Provider Relations leadership as needed.&nbsp;</li> <li>Provide other assistance as assigned to the Provider Relations team.</li> </ul> <p><strong><u>Required
Qualifications:</u></strong></p> <ul> <li>Bachelor’s degree preferred.</li> <li>2+ yrs. of experience in healthcare, pharmacy credentialing, contracting, provider relations, pharmacy, account management or other relevant experience.</li> <li>Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.</li> <li>Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to pharmacy providers to close out contracts and tasks.</li> <li>Ability to work independently, track work/projects appropriately and remain on task.</li> <li>Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders.</li> <li>PBM and pharmacy technician experience preferred.</li> </ul><div class="content-pay-transparency"><div class="pay-input"><div class="title">New York, NY Salary Range</div><div class="pay-range"><span>$56,800</span><span class="divider">&mdash;</span><span>$71,000 USD</span></div></div><div class="pay-input"><div class="title">Denver, CO Salary Range</div><div class="pay-range"><span>$52,000</span><span class="divider">&mdash;</span><span>$65,000 USD</span></div></div><div class="pay-input"><div class="title">Charlotte, NC Salary Range</div><div class="pay-range"><span>$47,200</span><span class="divider">&mdash;</span><span>$59,000 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.
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Job details
Salary
$47,200 - $71,000
Location
Colorado, Charlotte + 3 more
Funding
Total raised
$762M
Last stage
Series F
Investors
Founders
Ryan Kelly
Co-Founder & CTO
What happens next.
No applications, no recruiter spam. Just the intro.
Confirm the fit
A few questions to make sure this role is the right shape for you. Two minutes.
I pitch you to the company
I write the intro, send it to the founder, and handle the back-and-forth.
A meeting lands on your calendar
If they’re a yes, I book the chat. You show up — that’s the whole job-hunt.
