Clinical Programs Specialist

About Judi Health

Judi Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; Judi Health™, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and Judi®, the industry’s leading proprietary Enterprise Health Platform. To learn more, visit www.judi.health.

Job Summary

Acts as a dedicated specialist responsible for leading administrative and operational tasks to facilitate the execution of clinical programs and clinical initiatives, including but not limited to, triaging incoming calls, conducting outreach, managing and maintaining drug lists, and supporting reporting requirements.

Key Responsibilities

• Work with the Clinical Programs team to triage incoming clinical programs calls, schedule appointments for consultations and conduct outreach to prescribers, pharmacies, and members.
• Lead administrative and operational tasks to support the implementation of clinical programs, including but not limited to Capital Rx’s pharmacogenomics, MTM (Medication Therapy Management), lower cost alternative solutions, opioid safety edits, cost containment, and other clinical initiatives as needed.
• Manage and maintain drug lists to support operations of clinical programs including periodic drug list maintenance, weekly and quarterly list reviews, and ad-hoc updates.
• Support reporting requirements, monitor claims, and ensure communication amongst all stakeholders including internal and external partners.
• Identify, document, and effectively communicate issues to appropriate internal stakeholders ensuring customers receive quality care and resolution meets all health and safety standards.
• Work collaboratively with internal business and clinical partners to support clinical program initiatives as required.
• Ensure customer satisfaction, demonstrate genuine compassion and care, and provide professional customer service in a fast paced, startup environment.
• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies.
• Uphold general business needs and operations as required.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Requirements

• Active, unrestricted pharmacy technician license.
• 2+ years of applicable experience in a clinical pharmacy setting PBM, health plan, or related health care experience.
• 1+ year of customer service experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication.
• Ability to balance multiple complex projects simultaneously with minimal direction.

Preferred Qualifications

• Medication Therapy Management (MTM) experience preferred.