For health plans & TPAs

Flexible, scalable health benefits administration solutions for health plans, built on modern technology

From full-service health benefit administration to innovative “virtual PBM” solutions, Judi Health can help you advance health benefit programs.

Talk to Our Team

“Judi has a huge advantage in that we designed our technology from scratch, with a clean sheet of paper. We considered the workflows involved in administering commercial, Medicare, and Medicaid plans, and what could be done better - how to make it more accurate and provide a better customer and member experience.”

AJ Loiacono

Co-Founder & CEO

Challenge

Leave the headaches, struggles, and delays that come with the legacy systems behind.

You need a true partner, not a competitor, with next-generation technology who puts your members first and supports your infrastructure needs.

Aligned

No hidden fees or conflicting incentives, just support and service for your health plans, members, and future.

Efficient

All health benefit-related operations are connected and workflows are streamlined on one unified platform.

Flexible

Choose full-service or pick and choose any combination of services to meet you and your members’ needs.

Our solution

A new industry standard for health technology

Judi is far more efficient, configurable, and scalable than legacy systems - giving health plans a better way to manage pharmacy and medical benefit administration.

Usability

Configurability

Testing & QA

Edits

Plan Configuration

Intuitive UI Empowers

Designed for Unlimited Customization

Instantaneous Batch Testing

Edits take Minutes

30–60 Minutes

Complex UI Requires SMEs

Limited Off-The-Shelf Configurations

Manual QA Process

Edits take Months

30–60 Days

Other Platforms

How it works

Maximum flexibility, minimum hassle

From Judi’s expert implementation, client service, and member care teams to our modular approach, we are here to meet your commercial, Medicare, or Medicaid plan needs.

Prior Authorization

Streamline reviews, boost efficiency, and optimize outcomes with one platform.

Formulary Management & UM Management

Manage formulary ingestion and automate utilization management.

Data Analytics & Reporting

Run real-time reports and manage eligibility, accumulations, reporting, file delivery, and retrieval.

All Network and Pricing Structure Accommodations

Financially aligned to your goals with complete transparency.

Open API Architecture

Built to be interoperable, with 130+ APIs available for adjudication, PA, identity and access management, and more.

Clinical Programs

World-class clinical programs that enable plan sponsors to improve outcomes while lowering costs.

24/7 World-Class Call Center

Award-winning, multi-lingual, USA-based team, always available to help.

Invoicing and Payments

Seamlessly manage claims and ancillary invoicing for clients.

Security & Accreditations

Trusted protections and recognized accreditations.

Built on trust, accountability, and nationally recognized standards.

Rigorous Security Framework

We base our security program around FISMA NIST 800-53 controls which are rigorous and detailed.

Serverless Architecture

We utilize serverless architecture which is more difficult to compromise.

Real-Time Monitoring

We monitor our environment in real-time for any unexpected behavior, malware, and vulnerabilities using leading edge security systems.

Minimized Attack Surface

Our serverless model minimizes the attack surface of ransomware threats.

AWS-Backed Protection

Use of fully-managed AWS services leverages security expertise and scale of AWS.

Content Filtering

Extensive content filtering to end users helps minimize risk.

Choose a benefit administration partner committed to advancing transparency and meeting your plan’s and members’ needs

Replay: The Future of Health Benefit Design: How Judi® Powers Seamless Care and Better Outcomes

Partnership & Collaboration: Why PBMs and Health Plans Should Sync on Regulatory Change Management

How Our Favorite New Judi® Features Aid Government Programs

It's time to build your benefits, your way.

Get in touch to learn about our health benefit administration and transparent pharmacy benefit management solutions.

Talk to Our Experts