Hybrid Manager, Pharmacy Pricing Appeals

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About the role

  • Manager of Pharmacy Pricing Appeals for Judi Health managing pharmacy interactions regarding pricing appeals. Ensuring equitable reimbursement outcomes and maintaining relationships with pharmacy partners.

Responsibilities

  • Lead the review and improvement of the pharmacy pricing appeal process.
  • Manage intake pharmacy pricing appeals or claims reviews.
  • Collaborate with pharmacies and internal teams to reach equitable reimbursement outcomes.
  • Maintain accurate records of appeals and generate reports on trends and discrepancies.

Requirements

  • Bachelor’s degree required.
  • 5+ yrs. of experience in reviewing claims or payment appeals in healthcare, pharmacy, PBM, or other relevant experience.
  • In-depth knowledge of pharmacy operations and drug pricing.
  • Familiarity with PBMs and their role in pharmacy reimbursement.
  • Strong analytical and problem-solving skills.
  • Strong project management skills.
  • Excellent communication and interpersonal abilities.
  • Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.

Benefits

  • Health insurance
  • Retirement plans
  • Paid time off
  • Flexible work arrangements

Job title

Manager, Pharmacy Pricing Appeals

Job type

Experience level

Mid levelSenior

Salary

$95,000 - $130,000 per year

Degree requirement

Bachelor's Degree

Location requirements

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