Clinical Programs Lead — AI-Driven Health Outcomes

Judi Health; Charlotte, Denver, New York (NC, CO, NY); Hybrid; USD 135,000 - 145,000; Full time

Job summary

Judi Health in Charlotte, NC, is seeking a Clinical Programs Manager to lead development and optimization of clinical programs for pharmacy and medical benefits. You will oversee program life cycles, ensure value, quality, and outcomes, and collaborate across analytics, product, finance, marketing, client services, and vendors.

Responsibilities include developing, implementing, and maintaining programs (drug utilization review, adherence, disease management, pharmacogenomics), guiding

Qualifications

• 2+ years of health plan/PBM/managed care and/or clinical program management experience and/or completion of a PGY1 Managed Care Pharmacy Residency Program or fellowship required
• Excellent communication (oral and written) and organizational skills
• Ability to work independently with minimal supervision, stay productive in a hybrid, fast paced environment
• Self-motivated and detail-oriented problem solver
• Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team
• Experience with clinical analytics, reporting, and/or working with large data sets

Responsibilities

• Collaborate with stakeholders to develop, implement, and maintain clinical programs across all lines of business, including but not limited to drug utilization review, opioid management, adherence, pharmacogenomics, disease management, and other clinical initiatives
• Partner with cross-functional teams to ensure successful program planning, implementation, execution, and ongoing management
• Maintain and update clinical program resources, including drug lists, clinical rules, job aids, call scripts, SOPs, training materials, and related documentation
• Provide pharmacist expertise for program workflows, outreach strategies, prescriber communications, and clinical decision-making
• Own relationship with and provide oversight of third-party vendors to administer clinical programs with emphasis on disease management
• Support the go-to-market strategy of clinical products including pricing, marketing, and implementation
• Support RFI and RFP submissions
• Partner with internal and external stakeholders to support program launches, workflow enhancements, reporting initiatives, client implementations, and clinical projects
• Monitor program performance, claims activity, and reporting requirements while ensuring effective communication among stakeholders
• Identify operational trends and recommend process improvements that enhance quality, efficiency, member outcomes, and program effectiveness
• Support manager and department initiatives through special projects, operational support, and cross-functional collaboration
• Assist with staff training, onboarding, and development activities as needed
• Serve as preceptor for student pharmacists and residents as required

Skills

Communication skills

Organizational skills

Independent work

Problem solving

Attention to detail

Team collaboration

Clinical analytics

Education

PGY1 Managed Care Pharmacy Residency

Tools

Confluence

Jira

Tableau

Salesforce

Job description

Judi Health in Charlotte, NC, is seeking a Clinical Programs Manager to lead development and optimization of clinical programs for pharmacy and medical benefits. You will oversee program life cycles, ensure value, quality, and outcomes, and collaborate across analytics, product, finance, marketing, client services, and vendors.

Responsibilities include developing, implementing, and maintaining programs (drug utilization review, adherence, disease management, pharmacogenomics), guiding