Judi Health

Judi Health is a healthtech platform that provides pharmacy benefit management solutions.

501-1000 employees

Pharmaceutical

Private Company

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Pharmaceutical Medical Health Care

Remote Work Available

This company offers remote work opportunities.

Open Positions10

Remote, US Salary RangeFull-TimePharmacy benefitsPosted

Lead Utilization Management Pharmacist

Perform and oversee prior authorization and appeal reviews, override requests, and inbound and outbound member and provider education calls.
Support the training and development of staff and provide guidance on best practices for clinical pharmacy services.
Contribute to quality improvement initiatives and lead projects to improve pharmacy operations, member care, and clinical outcomes.
Collaborate with business, clinical, compliance, and quality assurance partners to improve workflows and identify risk mitigation strategies.
Serve as a subject matter expert on clinical medication reviews and provide consultation to the pharmacy team, providers, and other stakeholders.
Monitor review queues for regulatory and internal compliance and ensure timely, accurate processing of clinical reviews.
Make clinical decisions using medical necessity and contract criteria, supported by scientific literature and drug resources.
Review pharmacy claims data to identify opportunities for proactive outreach and intervention and monitor inappropriate care trends.
Maintain quality, productivity, and turnaround-time standards and provide backup support to the call center as required.

MS OfficeCustomer service

Showing 1 of 10 positions

Company Overview

Judi Health is a health technology company that provides benefit administration solutions. The company supports employers, unions, health plans, and government entities. Judi Health consolidates pharmacy and medical benefit administration onto a single platform. Their approach aims to provide price transparency and utilizes AI-powered care delivery. The company's products include Judi, a cloud-based enterprise health platform, Capital Rx for pharmacy benefit management, Judi Health for full-service health benefit management, Judi Care for care navigation, Never Move Again for unbundled pharmacy benefit management, and Capital Equilibrium, a level-funded pharmacy benefit management program. Judi Health has surpassed five million contracted PBM lives and administers benefits for over 50 million individuals across commercial, Medicare, and Medicaid plans.

Work Environment and Culture

Judi Health states that it values a diverse workplace and ensures equal employment opportunities. The company prohibits discrimination and harassment based on characteristics such as 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 law. All employees are responsible for adhering to the Judi Health Code of Conduct. For remote positions, employees must have a designated workspace that is visibly secure from others during work hours and protected from noise. A reliable high-speed internet service via DSL, cable, or fiber with a wired connection to the work device is required.

Technology and Engineering

Judi Health utilizes its cloud-native enterprise health platform, JUDI. The company's technology stack includes Content Delivery Network, Google Tag Manager, Cloudflare CDN, IPv6, Cloudflare Network Error Logging, jsDelivr, Cloudflare DNS, Google, CloudFront, and CrUX Top 50m. Job postings indicate a need for experience with relational databases and SQL, as well as API testing tools such as PostMan and SOAPUI. The company works with Agile methodologies. For specific roles, experience with Atlassian products is required. The Quality Assurance Manager role involves scaling test automation strategies across large or complex applications, using front-end automation tools like Playwright and Cypress, scripting in Python, JavaScript, or TypeScript, and working with middleware/API testing, SQL, Linux/Unix systems, CI/CD tools, AWS, and DevOps pipelines. Judi Health is deploying AI-powered care delivery.

Working at Judi Health

Judi Health operates in New York, New York, and has other locations in Charlotte, North Carolina, and Denver, Colorado. Many roles are offered remotely. Remote positions require a designated, visibly secure workspace and a wired high-speed internet connection of at least 940 Mbps. Specific job roles, such as the Lead Utilization Management Pharmacist and Appeals Technician, require working certain shifts, including evenings, weekends, and holidays on a rotating basis. The Medical Director role includes weekend on-call responsibilities. The company emphasizes a fast-paced environment with shifting priorities.

Benefits and Perks

Judi Health provides medical, dental, and vision benefits. The company offers a 401k plan, flexible time off, paid holidays, and sick days. Other benefits include performance-based bonus programs, health savings accounts (HSA), and commuter benefits. The company also offers growth and learning opportunities.

Tech Stack

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