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About the Role

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. We are rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.

Responsibilities

• Supports weekly, monthly, and quarterly maintenance and quality assurance checks of standard and custom formularies for all lines of business.
• Assists pharmacists in operationalizing and implementing custom client formulary and benefit requests.
• Triages and assists with Salesforce cases for custom formularies.
• Triages and monitors the Formulary Operations inbox.
• Uploads formulary composites and supports Benefits team testing.
• Assists pharmacists with cross-functional support for claim troubleshooting.
• Reviews formulary testing output templates for accuracy.
• Supports the creation, maintenance, and validation of client and formulary marketing materials.
• Conducts adjudication system maintenance data entry activities.
• Inputs inactive to active NDC updates.
• Performs supplemental list updates in Medispan.
• Creates non-formulary tier flips.
• Performs weekly formulary updates for Liberty, Freedom, and standard HIM formularies.
• Performs weekly moratorium updates and utilization management updates.
• Performs monthly Specialty formulary updates.
• Provides support to weekly New Drug to Market updates.
• Assists with creating job aids for Formulary Operations.
• Develops and maintains departmental SharePoint sites.
• Completes assigned work plan objectives and projects on a timely basis.
• Ensures quality assurance and formulary accuracy.
• Supports quality improvement projects.
• Supports RFI and RFP submissions.
• Supports general business needs and operations.
• Performs other duties and responsibilities as needed.

Requirements

• Registered Pharmacy Technician license.
• Certification from the National Pharmacy Technician Certification Board or National Health career Association or equivalent experience.
• 3-4 years of pharmacy experience working for a health plan or PBM.
• Formulary development and maintenance process experience at a PBM or health plan including experience with custom client benefit and formulary design highly preferred.
• Proficient in Microsoft office suite with emphasis on Microsoft Excel including advanced Microsoft Excel functions, VBA, macros, etc.
• Experience working with large datasets required.
• Knowledge of pharmacy claims processing drug names, and pharmacy/medical terminology.

Skills

• Microsoft Excel
• VBA
• Macros
• Salesforce
• Medispan
• SharePoint

Location

• New York, NY
• Denver, CO
• Charlotte, NC

Work Type

• Full-time

Experience Level

• 3-4 years

Education Level

• Pharmacy Technician license
• Certification from the National Pharmacy Technician Certification Board or National Health career Association

Salary/Compensations

• $70,000—$85,000 USD

About the Company

• Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans.
• Judi Rx delivers full-service pharmacy benefit management (PBM) solutions to self-insured employers.
• Judi Health™ offers full-service health benefit management solutions to employers, TPAs, and health plans.
• Judi® is 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.
• To learn more, visit www.judi.health.

Equal Opportunity

• 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.