Supervisor, Utilization Management Pharmacist
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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.
About the role
Join a mission-driven team where your leadership directly enhances patient care. In this role, you'll oversee a group of clinical pharmacists, support key clinical programs, and stay engaged in hands-on clinical work like prior authorizations and provider outreach. You'll also play a vital role in mentoring staff, optimizing workflows, and collaborating across teams. This is a great opportunity for pharmacists looking to grow their careers while making a meaningful impact—all in a fully remote, high-performing, and collaborative environment.
Responsibilities
- Supervise a group of clinical pharmacists handling phone escalations from members, prescribers, and pharmacists, prior authorization reviews, and clinical programs outreach.
- Participate in the goal setting process and regularly review performance of direct reports, providing coaching when needed.
- Support ongoing training of current staff and onboarding new clinical pharmacists, including developing and maintaining job aids and/or policies and procedures.
- Work in conjunction with other leadership in analyzing available data and provide staffing, workflow, and system enhancement recommendations.
- Identify and apply career development opportunities for employees.
- Perform day-to-day clinical pharmacy functions including prior authorization and appeal reviews, override requests, and inbound and outbound member and provider education or peer-to-peer calls.
- Meet or exceed performance metrics while maintaining quality and providing superior customer service to all stakeholders.
- Provide support for clinical programs as needed, including triaging incoming clinical calls and conducting outreach calls to prescribers, pharmacies, and members.
- Provide on-call support as needed for after-hours pharmacist/clinical programs/emergent calls on a rotating schedule that includes nights, weekends, and holidays.
- Work collaboratively with internal business and clinical partners to support initiatives including clinical interventions, clinical programs, data and claims review, and onboarding of new clients, as required.
- Support Manager, Utilization Management with additional duties as assigned.
Requirements
- Active, unrestricted pharmacist license.
- Bachelor's or Doctor of Pharmacy Degree with 2+ years of pharmacy practice experience.
- Experience in customer service, call center, and prior authorization.
- 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.
- Self-motivated and detail-oriented problem solver.
- Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team.
- Designated workspace (an office, spare bedroom, etc.) that is visibly secure from others during work hours (closed door) and is protected from noise that could disrupt conversations.
- Internet connectivity: DSL, cable modem, or fiber with a wired connection to device (wi-fi not allowed). Internet speed of one gigabyte (940bps) is required.
- Working knowledge of MS Office.
- 2+ years of experience as a clinical pharmacist in a Pharmacy Benefit Management (PBM) setting.
Qualifications
New York, NY location.
Pay
- New York, NY Salary Range: $128,000 USD - $160,000 USD
- Denver, CO Salary Range: $117,600 USD - $147,000 USD
- Charlotte, NC Salary Range: $106,800 USD - $133,500 USD