Integrated Benefits Operations Lead

Judi Health; Charlotte, Denver, New York (NC, CO, NY); Híbrido; USD 80 000 - 85 000; Tempo integral

Resumo da oferta

Judi Health is seeking a Benefit Operations Specialist to lead benefit configuration, claims testing, and QA across client implementations. You will help deliver integrated medical and pharmacy benefit programs and influence operational best practices within a fast-moving health tech space.

The role involves configuring new plans, performing tests and audits, and coordinating with product/dev teams to meet client needs, including government program expansions, while maintaining quality and SLA

Qualificações

• 3+ years of TPA / health plan experience in medical benefit configuration, testing, or related areas.
• Experience with Cigna or Aetna preferred.
• Pharmacy, Dental, or Vision experience a plus.
• Self-funded plans, Medicare/government programs and ERISA experience preferred.

Responsabilidades

• Configure, set up new plans and changes, run claims testing and audits.
• Collaborate across product/dev and stakeholder teams to tailor configurations for clients.
• Explain testing processes and test claims to non-experts clearly.

Conhecimentos

TPA experience

Agile methodology

Communication skills

SQL / data viz

Ferramentas

Excel

SQL

Data viz tools

Descrição da oferta de emprego

Judi Health is seeking a Benefit Operations Specialist to lead benefit configuration, claims testing, and QA across client implementations. You will help deliver integrated medical and pharmacy benefit programs and influence operational best practices within a fast-moving health tech space.

The role involves configuring new plans, performing tests and audits, and coordinating with product/dev teams to meet client needs, including government program expansions, while maintaining quality and SLA