Pharmacy Claims Analytics Specialist

Judi Health, LLC; Colorado; Hybrid; USD 122,000 - 189,000; Full time

Job summary

Judi Health, LLC in the United States is seeking a highly analytical Analyst to join our Analytics team and support pharmacy claims integrity, adjudication validation, and operational excellence. This role uses SQL and large-scale pharmacy claims data to investigate outcomes, identify discrepancies, validate benefit configurations, and ensure claims adjudicate accurately.

You will collaborate with Finance, Legal, Product, Operations, Network, and Compliance to interpret requirements, support

Qualifications

• 4-6 years of experience in healthcare analytics, pharmacy analytics, PBM operations, claims auditing, or a related field.
• Advanced SQL skills with the ability to analyze large, complex datasets.
• Experience performing pharmacy reimbursement, network pricing, financial reconciliation, contract compliance, or payment-integrity analysis.
• Ability to interpret complex contractual pricing terms and convert them into documented calculations, validation rules, and analytical test cases.
• Experience investigating discrepancies across claims, pricing reference data, contract terms, adjudication logic, and financial outputs.
• Demonstrated ability to quantify financial exposure and communicate material findings, assumptions, and limitations to stakeholders.

Responsibilities

• Analyze and Validate Pharmacy Claims using SQL and other analytical tools.
• Partner Across Functional Teams to interpret requirements and assess claim-processing outcomes.
• Deliver High-Quality Analytics through dashboards, reports, and reproducible analyses.
• Support Risk Management and Compliance by identifying financial, operational, and regulatory risks.

Skills

Advanced SQL

Pharmacy analytics

PBM operations

Data analysis

Job description

Judi Health, LLC in the United States is seeking a highly analytical Analyst to join our Analytics team and support pharmacy claims integrity, adjudication validation, and operational excellence. This role uses SQL and large-scale pharmacy claims data to investigate outcomes, identify discrepancies, validate benefit configurations, and ensure claims adjudicate accurately.

You will collaborate with Finance, Legal, Product, Operations, Network, and Compliance to interpret requirements, support