PGY1 Managed Care Resident

About Judi Health

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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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.

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 www.judi.health.

APPLICATION DEADLINE: JANUARY 4, 2027 Applications will not be reviewed until after January 4, 2027.

Open Positions: 3

Location: Hybrid in the New York, Charlotte, or Denver office. Candidates must be able to work in a hybrid environment and report to one of these offices.

About the Residency Program

Established in 2021, the Judi Health PGY1 Managed Care Residency Program offers a variety of learning experiences within a unique PBM setting. Residents build a strong foundation in clinical and managed care principles through structured rotations, cross-functional collaboration, and applied project work.

Position Summary

The PGY1 Managed Care Resident supports safe, clinically appropriate, and cost-effective medication use while developing broad experience across managed care pharmacy. The resident contributes to formulary management, clinical programs, benefit operations, utilization management, analytics, client support, and strategic business initiatives for commercial, Medicare, Medicaid, and health insurance marketplace clients. The role combines hands-on operational responsibility with structured learning experiences designed to build clinical judgment, business acumen, and leadership skills.

Core Learning Experiences

- Clinical Programs

- Formulary Operations

- Government Formulary Operations

- Benefit Operations

- Government Programs

- Clinical Call Center Operations and Prior Authorization

- Client Management

- Solutions Architecture and Product

- Executive Pharmacy Leadership

- Elective rotations based on resident interest and availability

Position Responsibilities

- Support initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients.

- Participate in the development and maintenance of formularies across multiple lines of business.

- Analyze pharmacy cost of care and utilization trends and support the development of utilization management edits, including step therapy, prior authorization, and quantity limits.

- Support the design of pharmacy benefits based on client-specific elections.

- Create pharmaceutical pipeline newsletters, publications, and presentations.

- Serve as a clinical resource, including support for the prior authorization unit and clinical call center.

- Analyze utilization data and create reports for group plan sponsors, including employers and labor unions.

- Participate in the development and maintenance of clinical programs such as drug utilization review, medication therapy management, adherence, and disease management programs.

- Evaluate industry data and make recommendations to improve clinical programs, clinical offerings, and the overall value proposition.

- Support the clinical client management team, as needed.

- Observe and participate in committee activities related to the pharmacy program.

- Design, manage, and complete a clinical residency project for presentation at a conference, with the intent to publish research findings.

- Supervise pharmacy students and support the continued development of the student program, includin