Utilization Management Technician Trainer

Описание вакансии

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health.

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Summary

We are seeking a dynamic and experienced technician trainer to join our team. As a technician trainer, you will play a pivotal role in developing and delivering training programs that enhance knowledge, operational efficiency, and customer service skills to our technician staff. The successful candidate will have a strong background in pharmacy practice, a passion for education, and the ability to create engaging and impactful training content.

Position Responsibilities:

• Facilitate the onboarding process for new hires and provide comprehensive training sessions for technicians on prior authorization systems, processes, and procedures utilizing a variety of training methods.
• Develop and update training materials, resources, verbiage templates, job aids, and communicate updates to the team.
• Ensure that training content is accurate, up-to-date, clinically relevant, compliant with federal and state regulations, and internal policies.
• Maintain detailed records of training sessions, participant attendance, and training materials for auditing and reporting purposes.
• Assess performance of technicians through evaluations, quizzes, and practical assessment to identify areas for improvement and provide constructive feedback.
• Collaborate with technician managers, supervisors, and other relevant stakeholders to identify training needs, performance gaps and ensure alignment with company goals.
• Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.
• Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review.
• Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
• Review and analyze pharmacy claims data for proactive outreach and intervention.
• Works with leadership on other responsibilities, projects, implementations, and initiatives as needed.
• Ability to work in a fast-paced environment with shifting priorities.
• Shift 9:00 AM to 6:00 PM EST.

Required Qualifications:

• 2+ years of pharmacy technician experience in Pharmacy Benefit Management (PBM) setting.
• National Certified Pharmacy Technician (CPhT) license, required.
• Previous experience developing and delivering training programs.
• Experience handling prior authorization requests/understanding of prior authorization requirements required.
• Solid understanding of prior authorization operations, Federal and State laws, and regulations.
• Excellent written communication and presentation skills to effectively convey complex information to diverse audiences.
• Excellent analytical skills and attention to detail.
• Ability to collaborate effectively with cross-functional teams and adapt to changing priorities.
• Proficiency in using e-learning platforms, multimedia tools, and Microsoft Office Suite.
• Have the following internet connectivity: DSL, cable modem or fiber with a wired connection to device (wi-fi not allowed). Internet speed of one gigabyte (940bps) is required.

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

*Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.*

Salary Range

$72,000—$85,000 USD

All employees are responsible for adherence to the Capital Rx 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.

Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.