Staff Analyst, Analytics - Pharmacy Payment Integrity & Analytics

<div class="content-intro"><h2><strong>About Judi Health</strong></h2> <p>Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. 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.<br><br>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 <span><a href="http://www.judi.health" target="_blank">www.judi.health</a></span>.</p></div><p><span data-contrast="none">Location:<em> </em>Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)</span></p> <p><strong><span data-contrast="none">Position Summary:</span></strong><span data-ccp-props="{"201341983":2,"335557856":16777215,"335559739":240,"335559740":240}"> </span></p> <p><span data-contrast="none">We are seeking a highly analytical Analyst to join our Analytics team and support pharmacy claims integrity, adjudication validation, and operational excellence. This role will use SQL and large-scale pharmacy claims data to investigate claim outcomes, identify discrepancies, validate benefit and pricing configurations, and ensure claims adjudicate accurately and in accordance with contractual and regulatory requirements.</span><span data-ccp-props="{"134233117":false,"134233118":false,"201341983":2,"335559738":240,"335559739":240,"335559740":300}"> </span></p> <p><span data-contrast="none">The ideal candidate combines strong analytical and technical skills with a natural curiosity for understanding how pharmacy claims are processed. They will work closely with Finance, Legal, Product, Operations, Network, and other cross-functional stakeholders to investigate issues, quantify impacts, support audits, and drive process improvements. This individual will play a key role in protecting financial accuracy, mitigating risk, and ensuring a high-quality member and pharmacy experience.</span><span data-ccp-props="{"134233117":false,"134233118":false,"201341983":2,"335559738":240,"335559739":240,"335559740":300}"> </span></p> <p><span data-ccp-props="{"134233117":true,"134233118":true,"201341983":2,"335559739":0,"335559740":300}"> </span></p> <p><strong><span data-contrast="auto">Key Responsibilities:</span></strong><span data-contrast="auto"> </span><span data-ccp-props="{"134233117":true,"134233118":true,"201341983":2,"335559739":0,"335559740":300}"> </span></p> <ul> <li><strong><span data-contrast="auto"><span class="TextRun MacChromeBold SCXW243714175 BCX0" lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW243714175 BCX0">Analyze and Validate Pharmacy Claims</span></span><span class="EOP Selected SCXW243714175 BCX0" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335559685":720,"335559737":0,"335559738":0,"335559739":0,"335559740":240,"335559991":360}"> </span></span></strong> <ul> <li data-leveltext="o" data-font="Courier New" data-listid="6" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Courier New","469769242":[9675],"469777803":"left","469777804":"o","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="2"><span data-contrast="auto"><span class="TextRun SCXW230571229 BCX0" lang="EN-US" data-contrast="none"><span class="NormalTextRun SCXW230571229 BCX0">Use SQL and other analytical tools to review pharmacy claims data and </span><span class="NormalTextRun SCXW230571229 BCX0">validate</span><span class="NormalTextRun SCXW230571229 BCX0"> adjudication outcomes.</span></span><span class="EOP Selected SCXW230571229 BCX0" data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></span></li> <li data-leveltext="o" data-font="Courier New" data-listid="6" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Courier New","469769242":[9675],"469777803":"left","469777804":"o","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="2"><span data-contrast="auto"><span class="EOP Selected SCXW230571229 BCX0" data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}">I<span class="NormalTextRun SCXW34809994 BCX0">nvestigate claim pricing, benefit application, reimbursement calculations, accumulators, and other claim-processing logic to </span><span class="NormalTextRun SCXW34809994 BCX0">identify</span><span class="NormalTextRun SCXW34809994 BCX0"> discrepancies or errors.</span></span></span></li> <li data-leveltext="o" data-font="Courier New" data-listid="6" data-list-defn-props="{"335552541":1,"335559685":1440,"335559991":360,"469769226":"Courier New","469769242":[9675],"469777803":"left","469777804":"o","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="2"><span data-contrast="auto"><span class="EOP Selected SCXW230571229 BCX0" data-ccp-props="{"201341983":0,"33