Research and analyze pharmacy claims to ensure accuracy and contractual compliance across benefit setup, pricing, and guarantees
Perform audit risk assessments, annual logic reviews and ongoing monitoring activities
Analyze, reconcile and validate large datasets across multiple internal systems; develop and maintain SQL/Python queries for audit reporting and performance monitoring
Create audit deliverable reporting, quantify financial impact of potential and confirmed audit findings, and build dashboards to identify trends and risks
Identify and implement automation and process improvements across audit, reporting, and reconciliation workflows
Maintain and enhance code, reporting tools, and dashboards to improve reliability, efficiency, and scalability
Define and document technical requirements, data specifications, and methodologies to support transparency and repeatability
Collaborate with internal and technology teams to improve data quality, workflows, and controls
Provide ad-hoc analysis to support evolving business and audit needs
Required Qualifications
Bachelor’s degree in a quantitative or business-related field (e.g., Actuarial Science, Statistics, Economics, Finance, Data Analytics, or Business Administration)
2+ years of of experience in data analytics, audit, or a related role
Experience in healthcare, PBM, or pharmacy claims; knowledge of pharmacy benefits, pricing, guarantees, and pharmacy claims analysis preferred
Proficiency with SQL (Snowflake preferred), Excel, Tableau
Familiarity with Python and project management/version control tools (e.g., Jira, Confluence, GitHub)
Strong attention to detail with an intellectual and professional curiosity along with a passion for continuous improvement
Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
Effective communicator with both technical and non-technical stakeholders
Extremely flexible, highly organized, and able to shift priorities easily
New York, NY Salary Range
$96,800—$121,000 USD
Denver, CO Salary Range
$88,800—$111,000 USD
Charlotte, NC Salary Range
$80,800—$101,000 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.
