Judi Rx delivers transparent, member-focused PBM solutions, while Judi Care provides medical, vision, and dental benefits through Judi®, supporting millions of plan members across employers, unions, health systems, and government programs. Backed by General Catalyst.
About the role
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 .
What they're looking for
- Two (2) to five (5) years of experience in pharmacy auditing, PBM operations, pharmacy compliance, healthcare auditing, pharmacy practice, or a related field required
- Experience reviewing pharmacy claims, prescription documentation, inventory records, and third-party billing processes preferred
- Working knowledge of pharmacy benefit management operations, Medicare, Medicaid, and commercial pharmacy benefit programs preferred
- Experience utilizing audit, reporting, and data analytics tools to identify trends, anomalies, and recovery opportunities preferred
- Strong analytical, investigative, and problem-solving skills with the ability to identify complex billing and compliance issues
- Exceptional attention to detail and accuracy in reviewing documentation and preparing audit reports
More about this role
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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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
The Pharmacy Auditor is responsible for conducting comprehensive audits of network pharmacies to ensure compliance with contractual obligations, regulatory requirements, client expectations, and industry standards. This role evaluates the accuracy of pharmacy claims, prescription dispensing practices, inventory...
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