Judi Health
Health Technology
UtilizationManagementTechnician(Temp-to-Hire)
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Utilization Management Technician (Temp-to-Hire) at Judi Health. Skills: Prior authorization requests, Clinical information gathering. Prepare prior authorization requests. Validate prescriber and member information”
What You'll Achieve.
Ensure customer satisfaction; Provide quality resolution
Industry & Context.
High-volume call center environment
What They're Looking For.
Must Have
2+ years pharmacy technician experience, Experience handling prior authorization requests, National Certified Pharmacy Technician (CPhT) license, Ability to work independently, Ability to multi-task
Nice to Have
Associate's or bachelor’s degree
What You'll Do.
Prepare prior authorization requests
Validate prescriber and member information
Make outbound calls to providers
Obtain clinical information from prescribers
Review and analyze pharmacy claims data
Identify provider concerns
Document provider concerns
Escalate provider concerns
Triage phone calls from members
Triage phone calls from pharmacy personnel
Triage phone calls from providers
Ask applicable drug and client specific clinical questions
Communicate issues and resolutions to members
Communicate issues and resolutions to pharmacy staff
Communicate issues and resolutions to providers
Communicate issues and resolutions to internal stakeholders
Follow internal Standard Operating Procedures
Adhere to HIPAA guidelines
Adhere to Company policies
Ensure customer satisfaction
Provide extraordinary customer care
Provide quality resolution
How You'll Work.
Team & Collaboration
Collaborate in a team
Communication Scope
Writing skills
Full 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. Position Responsibilities: Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review. Review and analyze pharmacy claims data for proactive outreach and intervention. Identify, document, and escalate provider concerns to the appropriate internal team including various members of the Prior Authorization Team Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions. Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders. Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion i
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