Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.
Position Summary:
Judi Health is seeking a strategic, client-focused Clinical Account Consultant to support all aspects of clinical functions to service client clinical needs. In this role, you'll ensure client satisfaction, retention, and trend management, while providing clinical support to clients across all lines of business. You’ll collaborate directly with clients to develop and implement formulary and clinical strategies, support contract renewals, and contribute to clinical process improvements. If you’re passionate about delivering exceptional service with a focus on clinical excellence and driving healthcare innovation, we’d love to hear from you!
Position Responsibilities:
- Support clinical aspects of implementation for new clients, plans, plan changes, and other clinical plan set-up requirements. This may include gathering client clinical intent and plan requirements, building/coding plans and formularies, conducting peer-review quality control, and reviewing testing and claims output.
- Actively address all clients’ clinical needs including the management and implementation of custom formularies, clinical criteria, and clinical strategies.
- Comprehend and effectively explain formulary, benefit, and clinical programs to clients, including intervention components, member and plan experience, book of business experience, and regulatory requirements as it directly pertains to clinical functions.
- Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for formulary, clinical and plan management strategies.
- Analyze and interpret pharmacy claims data to identify clinical and plan trends and to offer insights for individual clients and across multiple clients.
- Communicate drug information to clients and respond to plan-specific clinical inquiries; support resolution of member-specific inquiries.
- Collaborate with cross-functional teams to support sales initiatives, requests for information (RFI), requests for proposal (RFP), and prospect presentations.
- Actively attend and contribute to sales meetings and client presentations with a focus on clinical operations and clinical account management.
- Lead key internal clinical operations initiatives and general business needs/operations, as required.
- Identify and contribute to clinical process improvement efforts.
- Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends.
- Responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance.
Required Qualifications:
- Doctor of Pharmacy (PharmD) degree from an accredited institution
- Current, unrestricted registered pharmacist license(s)
- Relevant experience of 3-5 years in a health plan or pharmacy benefits management (PBM)
- Direct account management experience supporting clients across multiple lines of business
- Proficient in Microsoft Office Suite with emphasis on Microsoft Excel
- Experience working with large datasets and analyzing raw data in Excel
- Ability to balance multiple complex projects simultaneously
- Exceptional written and verbal communication skills
- Flexible, highly organized, and able to shift priorities easily
- Attention to detail & commitment to delivering high quality work product
- Ability to travel and present to small and large groups
Preferred Qualifications:
- Completion of managed care residency, preferred
- Prior account management experience of at least three (3) years, preferred
- Prior experience with Medicare line of business, preferred
All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
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.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.
Skills Required
- Doctor of Pharmacy (PharmD) degree from an accredited institution
- Current, unrestricted registered pharmacist license(s)
- 3-5 years of relevant experience in a health plan or pharmacy benefits management organization
- Direct account management experience supporting clients across multiple lines of business
- Proficiency in Microsoft Office Suite, especially Microsoft Excel
- Experience working with large datasets and analyzing raw data in Excel
- Ability to balance multiple complex projects simultaneously
- Exceptional written and verbal communication skills
- Flexibility, strong organization, and ability to shift priorities easily
- Strong attention to detail and commitment to high-quality work
- Ability to travel and present to small and large groups
- Completion of a managed care residency
- At least three years of prior account management experience
- Prior experience with the Medicare line of business
What We Do
Judi Health is a 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™: full-service health benefit management for employers, TPAs, and health plans - Judi®: a single, scalable SaaS solution that health plans can utilize to manage all their claim workflows Through these solutions, Judi Health is executing on its mission to give our country the infrastructure it needs for the healthcare we deserve. To learn more, visit www.judi.health.
