Government Program Operations Specialist

Judi HealthDenver, CO
Hybrid

About The Position

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. The Government Programs Operations Specialist is a hands-on position responsible for coordinating the day-to-day operations and activities of the Government Programs Operations team. This position provides the candidate a career growth opportunity while learning about Medicare Part D, Medicaid and Exchange business.

Requirements

  • 3 + years of experience in an equivalent role
  • High school diploma
  • Organizational skills and a very keen eye for detail and accuracy.
  • A positive and upbeat attitude, and excellent interpersonal communication skills.
  • A commitment to delivering a high level of customer service, both internally and externally.
  • Flexibility to respond to a range of different work situations.
  • An ability to work under pressure and juggle multiple priorities at any given time.
  • An ability to work well independently and be an effective collaborator within and across teams.

Nice To Haves

  • Experience with Medicare Part D and/or Pharmacy Technician experience preferred
  • Experience working in high-growth, startup environments - an advantage.

Responsibilities

  • Manage the Government Programs Operations team shared Outlook mailbox, including but not limited to timely, accurate and complete responses, and ensuring timeframes for deliverables.
  • Lead and execute pharmacy outreach initiatives related to CMS disputes, ensuring compliance with regulatory requirements and internal Government Operations procedures while applying judgment in communication strategy and issue resolution.
  • Serve as a key contributor in the validation of system enhancements, including evaluating output data, identifying discrepancies, and providing recommendations to improve system performance and data integrity.
  • Design, maintain, and continuously improve structured documentation frameworks, including job aids, policies and procedures (P&Ps), standard operating procedures (SOPs), and training materials to support operational consistency and scalability.
  • Develop and optimize internal workflows and job aids, driving process standardization and identifying efficiency opportunities across Government Programs Operations.
  • Oversee daily PDE reconciliation activities, analyzing trends, identifying variances, and proactively addressing discrepancies to ensure data accuracy and compliance.
  • Manage and resolve escalations arising from claims monitoring activities by applying critical thinking, root cause analysis, and cross-functional collaboration.
  • Support strategic Government Programs Operations initiatives, contributing insights, process improvements, and subject matter expertise as assigned.
  • Plan, coordinate, and facilitate cross-functional meetings to drive alignment, resolve issues, and advance operational objectives.
  • Collaborate closely with Government Programs Operations team members and business partners to address operational needs, improve processes, and support broader organizational goals.
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