Pharmacy Auditor

<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 Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single,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: Hybrid (Local to NYC, Denver or Charlotte areas)</span><span data-ccp-props="{&quot;134233117&quot;:true,&quot;134233118&quot;:true,&quot;201341983&quot;:2,&quot;335557856&quot;:16777215,&quot;335559740&quot;:300}">&nbsp;</span></p> <p><strong><u>Position Summary</u></strong></p> <p>The Pharmacy Auditor is responsible for conducting comprehensive audits of network pharmacies to ensure compliance with contractual obligations, regulatory requirements, client expectations, and industry standards. This role evaluates the accuracy of pharmacy claims, prescription dispensing practices, inventory records, and supporting documentation to identify billing discrepancies, recover overpayments, and promote program integrity.</p> <p>The Pharmacy Auditor plays a critical role in safeguarding healthcare resources by identifying operational, billing, and compliance risks within the pharmacy network. This position collaborates closely with Compliance, Legal, Finance, Provider Relations, Clinical, and Fraud, Waste, and Abuse (FWA) teams to support corrective actions, recoveries, regulatory requirements, and education initiatives.</p> <p><strong><u>Position Responsibilities:</u></strong><u>&nbsp;</u></p> <ul> <li>Conduct desk, remote, and on-site pharmacy audits to evaluate pharmacy compliance with contractual, regulatory, and operational requirements.</li> <li>Review prescription records, claims data, purchase invoices, inventory documentation, dispensing logs, and other supporting records to validate the accuracy and legitimacy of billed claims.</li> <li>Analyz