Clinical Programs Specialist - Operations

About Judi Health

Judi Health is an enterprise 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™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.

Responsibilities:

• Lead administrative and operational tasks to support the implementation and operations of clinical programs, including pharmacogenomics, MTM, adherence, opioid safety, concurrent and retrospective drug utilization review, and other initiatives as needed
• Support clinical programs business development needs, including client contracting, vendor management, preparation of opportunity analyses, and program sales support
• Validate program identification and claim files, fax and letter communication proofs, vendor invoices, and client invoices for accuracy on a reoccurring basis
• Generate data outputs and analyze large data sets to monitor program quality and identify enhancement opportunities
• Manage large scale projects to support business needs
• Maintain drug lists to support operations of clinical programs including periodic drug list maintenance, weekly and quarterly list reviews, and ad-hoc updates
• Ensure customer satisfaction, demonstrate genuine compassion and care, and provide professional customer service in a fast-paced environment.
• Uphold general business needs and operations as required

Required Qualifications:

• 2+ years of applicable experience in a clinical pharmacy setting PBM, health plan, or related health care experience
• 1+ years of prior experience in business analysis, project management, or related fields
• Ability to manage multiple complex projects simultaneously with minimal direction
• Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
• Active, unrestricted pharmacy technician license

Preferred Qualifications:

• Proficient in querying large data sets, and coding languages are a plus
• Experience with Confluence, Jira, Tableau, Salesforce
• Experience with specialty pharmacy, home infusion, and related care coordination services
• Highly detail-oriented and analytical