Role overview

Qualifications

Bachelor’s degree
1+ years of previous work experience, preferably in PBM, Healthcare, Data Exchange, and Eligibility
Proficiency in SQL, Excel, JSON and other technical data skills preferred
Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders

Responsibilities

Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols
Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data
Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols
Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data

Key facts

Remote from: United States
Full time
Junior (1-2 years)
111 - 121K yearly
English

Hard skills

Enrollment Management Electronic Data Interchange SQL (Programming Language) Data Exchange JSON

Other skills

Microsoft Excel
Problem Solving
Communication
Teamwork
Time Management
Detail Oriented

About the company

Amino Health

Health, Sport, Wellness & Fitness

We are Amino Health, the leading data-driven healthcare guidance platform, that empowers plan members to easily navigate their unique plan designs and benefits to find proven, trustworthy care for their specific needs. Partnering with health plans, third-party administrators, benefits administrators and concierge care vendors, Amino connects members to high-value providers and facilities at three times the rate of the baseline population, driving cost savings, increased member satisfaction, and improved health outcomes.

Company details

Company typeScaleup

IndustryHealth, Sport, Wellness & Fitness

Company size51 - 200

Links

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Job description

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 Denver, CO or NYC area)

Position Responsibilities:

Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols
Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data
Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols
Serving as a point of coordination for member eligibility issue identification and issue resolution with internal teams and external partners
Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data
Proactively monitoring system status and eligibility data to quickly identify potential abnormalities that might impact quality and accuracy
Ensuring that all issues and errors are resolved using designated operating standards and within defined service levels
Assist with the validation of eligibility data integrity through regular audits and reconciliation processes
Ensure accurate and timely entry of group/plan structure determinations for benefits and enrollment
All employees are responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance.

Required Qualifications:

Bachelor’s degree
1+ years of previous work experience, preferably in PBM, Healthcare, Data Exchange, and Eligibility
Ability to match key PBM concepts and data fields across various systems and file layouts to ensure consistency and accuracy of data transfers
Ability to analyze complex business problems to discover and resolve root causes
Proficiency in SQL, Excel, JSON and other technical data skills preferred
Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders
Self-motivated and detail-oriented problem solver
Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team

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.

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.

Remote, US Salary Range

$76,800—$121,000 USD

New York, NY Salary Range

$96,800—$121,000 USD

Denver, CO Salary Range

$88,000—$111,000 USD

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 at https://www.judi.health/legal/privacy-policy.

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