Supervisor, Utilization Management Pharmacist

Supervisor, Utilization Management Pharmacist

Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States

About Judi Health

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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.

Position Summary: 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 impactall in a fully remote, high-performing, and collaborative environment.

Position Responsibilities:

• Responsible for the supervision of 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 on-going 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 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 on-boarding of new clients, as required.
• Support Manager, Utilization Management with additional duties as assigned.

Required Qualifications:

• 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 required
• 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
• Have a 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
• Have the following 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.

New York, NY Salary Range

$128,000 - $160,000 USD

Denver, CO Salary Range

$117,600 - $147,000 USD

Charlotte, NC Salary Range

$106,800 - $133,500 USD

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.