Lead Medicare Utilization Management Tech - Hybrid

Judi Health; Charlotte (NC); Hybrid; USD 78,000 - 85,000; Full time

Job summary

Judi Health in Charlotte, NC, is hiring to lead the prior authorization team within a fast-paced health technology environment. You will oversee technicians, analyze data with leadership, and help drive workflow improvements while ensuring compliance with HIPAA and internal SOPs.

The role requires Medicare experience and a strong clinical background, plus a national certification as a Pharmacy Technician. A collaborative, flexible attitude is essential in our startup-like setting with on-call

Qualifications

• Medicare experience required, including policies and guidelines.
• Minimum 1 year of Medicare Prior Authorization and/or Medicare appeals experience.
• Strong communication, writing, and organizational skills.
• Active, unrestricted National Certified Pharmacy Technician (CPhT) license required.
• Proficient in Microsoft Office Suite with emphasis on Excel and PowerPoint.
• Strong clinical background.
• Ability to multi-task and collaborate in a team with shifting priorities.

Responsibilities

• Oversee a group of prior authorization technicians and expanded responsibility for select administrative PA functions.
• Analyze data with the pharmacy technician manager to inform staffing, workflow, and system enhancements.
• Support ongoing training and coaching of utilization management pharmacy technicians.
• Review pharmacy claims data for proactive outreach and intervention.
• Prepare prior authorization requests with validated prescriber and member information and clinical guidelines.

Skills

Medicare experience

Medicare Prior Authorization

Communication skills

Organizational skills

Strong clinical background

Team leadership experience

Multi-tasking

Education

National Certified Pharmacy Technician (CPhT)

Tools

Microsoft Excel

Microsoft PowerPoint

Microsoft Office Suite

Job description

Judi Health in Charlotte, NC, is hiring to lead the prior authorization team within a fast-paced health technology environment. You will oversee technicians, analyze data with leadership, and help drive workflow improvements while ensuring compliance with HIPAA and internal SOPs.

The role requires Medicare experience and a strong clinical background, plus a national certification as a Pharmacy Technician. A collaborative, flexible attitude is essential in our startup-like setting with on-call