Provider Relations Specialist (Temp)

Judi Health, LLC; Charlotte, Denver, New York (NC, CO, NY); Hybride; USD 47 000 - 59 000; Plein temps

Avantages offerts par ce poste

Temporary-to-Full-time conversion

Résumé du poste

Judi Health, LLC is seeking a Provider Relations Specialist to support the Judi Rx network. The role focuses on credentialing pharmacies, managing licenses and attestations, and ensuring contract compliance.

The position is a six-month temporary engagement with potential conversion to full-time. The hybrid role requires at least 2+ years in healthcare or pharmacy credentialing, strong Excel/Word/PowerPoint skills, and the ability to work independently while coordinating with internal and

Qualifications

• 2+ yrs. of experience in healthcare, pharmacy credentialing, contracting, provider relations, pharmacy, account management or other relevant experience.
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.
• Proven track record of working in a fast-paced environment, managing multiple tasks and persistent outreach to pharmacy providers to close contracts and tasks.
• Ability to work independently, track work/projects and stay on task.
• Strong communication skills with the ability to develop effective relationships with providers and stakeholders.
• PBM and pharmacy technician experience preferred.

Responsabilités

• Manage credentialing for applicable pharmacies for inclusion in the provider networks and maintain the information related to credentialing, including licenses and certificates of insurance and verification in NCPDP, OIG, GSA, SAM.
• Ensure pharmacies are valid by reviewing exclusion lists and refer excluded pharmacies for removal.
• Develop and maintain a credentialing database to track all credentialing information.
• Handle credentialing reporting requests with internal teams.
• Manage annual attestations to ensure compliance with contracts and accreditation.
• Develop credentialing policies and procedures.
• Gather information from pharmacies about services and opportunities, and assist with contracting as needed.
• Provide other support to the Provider Relations team.

Connaissances

Credentialing

Provider relations

Contracting

Account management

Communication

Outils

Microsoft Excel

Microsoft Word

PowerPoint

Description du poste

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities.

By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health .

Location: Hybrid (at least 3 days per week in our NYC, Denver, or Charlotte offices)

Position Summary : The Provider Relations Specialist provides essential credentialing review and management to support the Judi Rx networks of pharmacies. This work involves deciding whether pharmacies meeting Judi Rx’s credentialing requirements allowing for inclusion in the Judi Rx pharmacy networks and maintaining the information related to credentialing. The ideal candidate will have experience in credentialing providers, managing reporting requests, and contribute to scalable solutions to streamline processes.

Six-month temporary engagement with possible conversion to full-time.

Position Responsibilities:

• Manage credentialing for applicable pharmacies for inclusion in the provider networks and maintain the information related to credentialing so that Judi Rx has the most relevant information available. This includes getting applicable licenses and certificates of insurance from pharmacies as well as verifying eligibility in the NCPDP database and federal and state websites (e.g. OIG, GSA, SAM).
• Ensure the applicable pharmacies are valid by reviewing exclusion lists on an ongoing basis to identify any excluded pharmacies and referring those pharmacies to the appropriate team members/departments for removal.
• Manage the development and maintenance of a credentialing database to ensure proper tracking of all relevant credentialing information.
• Manage credentialing reporting requests working with the appropriate internal teams.
• Manage gathering and tracking annual pharmacy required attestations to ensure compliance with contractual and accreditation requirements.
• Develop applicable credentialing policies and procedures.
• Gather pertinent information from pharmacies regarding services offered and opportunities and provide direct contracting support to Provider Relations leadership as needed.
• Provide other assistance as assigned to the Provider Relations team.

Required Qualifications:

• 2+ yrs. of experience in healthcare, pharmacy credentialing, contracting, provider relations, pharmacy, account management or other relevant experience.
• Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.
• Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to pharmacy providers to close out contracts and tasks.
• Ability to work independently, track work/projects appropriately and remain on task.
• Strong communication skills with the ability to develop effective working relationships with providers and internal and external stakeholders.
• PBM and pharmacy technician experience preferred.

New York, NY Salary Range

$56,800 - $71,000 USD

Denver, CO Salary Range

$52,000 - $65,000 USD

Charlotte, NC Salary Range

$47,200 - $59,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy .

U.S. Standard Demographic Questions

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Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Judi Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.