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Benefit Operations Specialist

Judi HealthDenver, Colorado, United States; New York, New York, United States; Remote
Remote Full-time $75K/yr - $90K/yr

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Position Responsibilities:Manage all aspects of benefit configuration, including new plan setups, plan modifications, claims testing, and regular audits. Facilitate collaboration across product development and stakeholder teams to ensure client-specific requests are effectively configured for both new and modified plans. Communicate benefit configuration setups and testing procedures to clients in a clear manner accessible to non-experts. Propose enhancements to streamline workflows and systems impacting plan/benefit design for improved efficiency and quality outcomes. Collaborate cross-functionally to develop new benefit options that align with market demands, including expansions in government programs. Create standards and custom testing scenarios, reviewing test claims to confirm accuracy against clients' benefit designs.

About the job

About Judi Health

Judi Health is a pioneering health technology firm dedicated to transforming healthcare delivery for employers and health plans. Our offerings include:

  • Capital Rx, a public benefit corporation that provides comprehensive pharmacy benefit management (PBM) solutions for self-insured employers.
  • Judi Health™, delivering full-service health benefit management solutions tailored for employers, TPAs, and health plans.
  • Judi®, our proprietary Enterprise Health Platform (EHP) that streamlines all claim administration workflows within a secure and scalable environment.

We are committed to rebuilding trust in the U. S. healthcare system and implementing the infrastructure necessary for the healthcare we deserve. For more information, visit www.judi.health.

Position Summary:

Join our innovative Integrated Benefits team as a Benefit Operations Specialist. In this key role, you will be instrumental in delivering comprehensive medical and pharmacy benefit programs for our clients at Judi Health. You will oversee benefit configuration, claims testing, and quality assurance processes, ensuring precision and efficiency in all implementations. This position provides the opportunity to shape operational best practices and be part of a team that is revolutionizing integrated benefits in healthcare.

About Judi Health

Judi Health is at the forefront of health technology, committed to modernizing the healthcare landscape through innovative solutions that enhance employer and health plan offerings. Our comprehensive suite of services is designed to improve healthcare delivery and foster trust among stakeholders.

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