Capital Rx
About Us
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.
Location Remote (U.S only)
Position Responsibilities
Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines
Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review
Proactively obtain clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
Review and analyze pharmacy claims data for proactive outreach and intervention.
Identify, document, and elevate provider concerns to the appropriate internal team including various members of the Prior Authorization Team
Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions.
Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders.
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment
Required Qualifications
2+ years of pharmacy technician experience in a PBM, health plan, or another clinical pharmacy setting
Experience handling prior authorization requests/understanding of prior authorization requirements required
National Certified Pharmacy Technician (CPhT) license, required
High school diploma or the equivalent; Associate’s or bachelor’s degree is preferred
Excellent communication, writing, and organizational skills
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
Ability to multi-task and collaborate in a team with shifting priorities
Salary Range $50,000—$60,000 USD
Equal Employment Opportunity Statement Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.
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Location Remote (U.S only)
Position Responsibilities
Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines
Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review
Proactively obtain clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
Review and analyze pharmacy claims data for proactive outreach and intervention.
Identify, document, and elevate provider concerns to the appropriate internal team including various members of the Prior Authorization Team
Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions.
Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders.
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment
Required Qualifications
2+ years of pharmacy technician experience in a PBM, health plan, or another clinical pharmacy setting
Experience handling prior authorization requests/understanding of prior authorization requirements required
National Certified Pharmacy Technician (CPhT) license, required
High school diploma or the equivalent; Associate’s or bachelor’s degree is preferred
Excellent communication, writing, and organizational skills
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
Ability to multi-task and collaborate in a team with shifting priorities
Salary Range $50,000—$60,000 USD
Equal Employment Opportunity Statement Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.
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