Current openings at Judi Health

Location: Remote (For Non-Local) or Hybrid (Local to Denver or NYC area)  Position Summary:  The Case Development Specialist supports both the Pharmacy Audit and the FWA investigation teams by ensuring that all cases are accurately initiated, risk-assessed, and prioritized according to established guidelines. This role serves as the operation backbone for the case intake, triage, and tracking process, verifying data integrity, performing initial analysis, and supporting case documentation from intake through closure. The Specialist ensures smooth operational flow from case intake through closure, maintaining organized files, supporting data validation, and preparing materials needed for auditors, investigators, and reporting requirements. Position Responsibilities:  Enter and track new cases for both Pharmacy Audit and FWA Investigation teams. Complete and document risk scores prior to case opening to determine priority level. Review incoming referrals for completeness and data accuracy. Maintain all cases files and supporting documentation in accordance with SIU standards. Prepare case information materials and letters for audits, investigations, and reporting. Support communication and document flow between teams. Track and report case activity, ensuring deadlines and quality standards are met. Enter, track and identify cases involving potential billing issues or referrals from members or providers. Track cases by documenting the timeline, interactions between internal teams and pharmacy, and escalating to Pharmacy Audit or FWA Investigation team as needed. Assess risk score using judgement and discretion. Analyze claims, prior authorization, and patient data to find patterns of abnormal utilization or fraud. Responsible for adherence to the Capital Rx Code of Conduct. Required Qualifications:  2+ years of experience in healthcare, PBM, or insurance (SIU or audit experience preferred). Strong organizational and data management skills with attention to detail. Proficiency with case management systems and Microsoft Office and Excel. Ability to handle confidential and sensitive information. Preferred Qualifications:  Associate or bachelor’s degree preferred.

Location: Remote or Hybrid (NYC, Denver)   Position Summary: Judi Health is looking for curious, motivated, and proactive students to join our term-time and summer internship program. Interns dive into meaningful projects from day one, gain exposure to strategic initiatives, and explore cross-functional teams in a fast-paced, mission-driven environment. Ideal candidates thrive on turning complexity into clarity and embody our core values: EXCELLENCE IN EXECUTION – Maintain an ownership mindset demonstrating the grit and determination to drive exceptional results INTEGRITY IN ACTION – Uphold the highest standards, doing what’s right even when unobserved, and holding ourselves and others accountable INNOVATIVE – Embrace innovation by thinking creatively, exploring out of the box approaches, and taking calculated risks with proper validation CUSTOMER OBSESSED – Aim to delight our customers and exceed client and stakeholder expectations with superior technology and service AGILE – Foster strong cross-functional collaboration through empowered teamwork, personal accountability, and proactive problem-solving DATA-DRIVEN – Utilize data-driven approaches for continuous improvement, effective problem-solving, and informed decision-making VALUE DIVERSE PERSPECTIVES – Celebrate and integrate diverse perspectives, backgrounds, and expertise RADICALLY TRANSPARENT – Courageously challenge industry norms, innovate beyond the status quo, and be direct yet respectful with feedback Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Internships are offered in-semester for varied lengths of time or during the summer. We offer multiple tracks to align with your academic background and career interests: Tracks: Track assignments may evolve based on business needs, intern interests, and emerging opportunities across the organization. The below are illustrative examples of project types:  Data and Analytics: Build dashboards and visualizations for internal and external stakeholders Support predictive modeling and data-driven decision-making Analyze healthcare datasets to uncover trends and inefficiencies Sales and Marketing Conduct market research and competitor analysis to inform positioning Assist with sales pipeline development, lead qualification, and funnel performance tracking to support revenue growth and team efficiency Collaborate on product storytelling and growth campaigns Product Contribute to product discovery, user research, and feature prioritization Assist in writing product requirements and collaborating with engineering Support usability testing and feedback synthesis Technology Help train and evaluate AI/ML models for clinical or operational use cases Build and maintain scalable applications and APIs Support infrastructure automation, CI/CD pipelines, and cloud operations Clinical Conduct research and data analysis Streamline workflows, improve documentation, and analyze utilization trends Assist in the development and evaluation of clinical programs through pilot design, outcomes tracking, and stakeholder coordination Corporate Operations Support initiatives through research, analysis, and cross-functional collaboration Assist with day-to-day operations, including process optimization and documentation Contribute to project management efforts by tracking milestones, coordinating stakeholders, and ensuring timely execution Legal Assist with contract review, compliance documentation, and policy research Support legal ops by maintaining internal databases, templates, and tools Contribute to regulatory filings and help ensure alignment with HIPAA, data privacy, and industry standards Finance Support FP&A activities including budgeting, forecasting, and variance analysis Assist with strategic finance initiatives Contribute to pharmacy revenue modeling and network performance analysis Required Qualifications: Currently enrolled in an Undergraduate or Master’s Degree Program Strong written and verbal communication skills, with the ability to collaborate across teams Demonstrated interest in healthcare, technology, or mission-driven innovation Analytical mindset with attention to detail and curiosity to solve complex problems Ability to manage multiple tasks, work independently, and adapt in a fast-paced environment For Masters students, previous work experience in a field or function relevant to the track is a plus but not required Proficiency in tools relevant to the track (e.g., Excel, Python, Figma, R, Tableau, CRM platforms, or research databases) is a plus but not required