Operations Manager Rx Jobs in Bloomfield, NJ (NOW HIRING)

About Judi Health

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,
• Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi, 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.

Location: Remote (For Non-Local) or Hybrid (Local to NYC area or Denver, CO)

Position Summary:

As a member of the Enterprise Solutions team, you will play a critical role in contributing to the success of Judi Health's customers leveraging Judi, our Enterprise Health Platform, to service their own pharmacy administrative needs. The Enterprise Solutions team seeks individuals who are passionate to change the landscape of claims processing while providing superior service. This individual will hold responsibility for the setup and ongoing maintenance of accumulator, claims and override data in Judi.

Position Responsibilities:

• Accountable for configuration, load, and maintenance of data from previous adjudication systems into Judi.
• Provide customers with subject matter expertise in Judi's capabilities, ensuring successful migration to the adjudication platform, with parity of all logic and initiatives.
• Devise a repeatable process for implementing data in Judi, establishing key milestones, and maintaining up to date project plan.
• Build and maintain trusting relationships with customers through superior customer service, meeting or exceeded service level metrics.
• Perform QA and claims testing to validate that data loads yield appropriate adjudication results.
• Partner with Analytics colleagues to author automated/manual test cases and monitoring processes for configurations and data loads.
• Proactively identify execution risks around build status and defects, partnering with internal Product teams and clients to surface mitigation strategies.
• Contribute to playbooks/templates that scale configurations for future client onboardings.
• Take charge of critical issues or problems to key stakeholders, ensuring swift resolution and communication within service level agreements.
• Certain times of year may require meeting participation, travel, service support or other requirements outside of standard business hours, including weekends.
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Minimum Qualifications:

• 1+ years of experience in an Analyst role, Software Engineering role or related work experience
• 1+ year of PBM or Health Plan operations experience handling adjudication configurations.
• Experience performing complex analyses on large sets of data
• Knowledge of data management, statistics, modeling
• Experience working with structured and unstructured data
• Proficient in SQL, JSON, Java, R, Excel, and other data visualization tools
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables.
• Exceptional project / time management, prioritization, and organizational skills to ensure customer satisfaction.
• Ability to shift between competing priorities and meet organizational goals.
• Excellent verbal, written, interpersonal and presentation skills.
• Ability to work effectively with virtual teams.
• Ability to travel 5-10%.

Preferred Qualifications:

• Bachelor's Degree preferred, or equivalent combination of education, training, and experience.

• Experience working with AWS Redshift

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, skills, and location of the job.

All employees are responsible for adherence to the Capital Rx 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.

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.

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 athttps://www.judi.health/legal/privacy-policy.