Judi Health - Benefit Configuration Specialist
Upload My Resume
Drop here or click to browse · Tap to choose · PDF, DOCX, DOC, RTF, TXT
Requirements
• Bachelor’s degree in Healthcare Administration, Business, Information Systems, or related field (or equivalent work experience). • Minimum 3–5 years of experience in pharmacy benefit management (PBM), health plan operations, or benefit configuration. • Direct experience supporting Medicare lines of business (Medicare Part D and/or MAPD). • Demonstrated understanding of Medicare benefit structures. • Experience testing and validating pharmacy benefit configurations in Commercial, Medicaid, Exchange, and/or Medicare lines of business. • Strong knowledge of formulary design, tier structures, utilization management (PA, ST, QL), and accumulator logic. • Ability to analyze benefit design documents and translate requirements into executable test scenarios. • Strong analytical skills with high attention to detail and accuracy. • Proficiency in Microsoft Excel for data review, validation, and reporting. • Strong written and verbal communication skills with ability to clearly document findings and discrepancies. • Participate in client-facing discussions to review benefit testing outcomes and implementation readiness while providing clear guidance on complex benefit designs.
Benefits
• New York, NY (hybrid) • Denver, CO (hybrid) • Remote - (final salary within this range is determined by the candidate's geographic location and applicable market tier) • This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and location of the job. • Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. • Judi Health provides all full-time and part-time benefit-eligible employees with the ability to elect medical and pharmacy coverage, dental insurance, vision insurance, accidental injury insurance, critical illness insurance, hospital indemnity insurance, and flexible spending accounts. Full-time employees also have access to a health savings account, voluntary life insurance, and voluntary accidental death and dismemberment insurance for themselves and their eligible dependents. • Judi Health provides full-time employees with the following benefits at no cost to the employee: basic life insurance, basic accidental death and dismemberment insurance, paid time off, sick time, holidays, short-term disability, long-term disability, an employee assistance program, and a wellness program. Full-time employees are also eligible for a 401(k) plan with company match after one year of full-time employment. • 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, • Capital Rx • Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and • Judi Health™, • Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. • Judi®, • 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.
No credit card. Takes 10 seconds.