Job Description

ABOUT RIGHTWAY

At Rightway we are committed to creating a diverse environment and are proud to be an equal opportunity employer. We hire for the best talent and actively seek diversity of thought processes, beliefs, background and education. Rightway fosters an inclusive culture where differences are celebrated to drive the best business decisions possible.

We are committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.

Rightway Healthcare was founded in early 2017 by a team of dedicated healthcare, business and technology leaders. Rightway is a technology platform that provides employees and their families with the support, information and advocacy they need to be better healthcare consumers. We combine a high-tech consumer portal with a high-touch dedicated concierge environment to provide consumers with the same level of support and guidance they would receive if they had a doctor in the family. We are focused on personalization, implementation, advocacy and results.

Rightway works with employers from 100 – 25,000 employees to provide an ecosystem of healthcare navigation for employees. We are committed to generating high member satisfaction scores, industry leading engagement and a quantifiable ROI for every employer. Our approach is rooted in analytics and guided by a bottom-up understanding of a population.

Rightway is privately financed, having raised over $100mm to date from investors such as Thrive Capital

It is headquartered out of New York City, with new offices in Hudson Yards. We also have remote offices in Miami, FL and San Francisco, CA.

 ABOUT THE ROLE

SEEKING CANDIDATES FOR ALL SHIFT SCHEDULES INCLUDING OVERNIGHT.

ROLE DESCRIPTION: The Pharmacy Customer Service Representative is a member of the RightwayRx Operations team reporting to the Sr Director of PBM Operations. This role works regularly with members and providers to resolve inquiries related to benefits, claim adjudication and utilization management.

TEAM DESCRIPTION: Our pharmacy benefit management (PBM) offering represents an important growth area for Rightway.  Helping clients better manage pharmacy spend to make drugs more affordable for their employees and dependents is critical to their business sustainability.  RightwayRx is responsible for designing, building and operating a new-to-the-world PBM model base on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers

RESPONSIBILITIES

• Handles calls and correspondence (electronic and written) regarding pharmacy benefit inquiries from providers (pharmacy/physician) and members.
• Effectively communicate issues and resolution to members and providers.
• Document calls within a call tracking system using established protocols to ensure resolutions are clear, concise, and accurate.
• Assist network pharmacies in processing prescription claims. Review claims for accuracy against benefit guidelines and contract standards.
• Serve as a customer advocate in problem resolution and follow through.
• Creates and supports and environment which fosters teamwork, cooperation, respect and diversity.
• Perform other duties and projects as assigned.

REQUIREMENTS

• Education level: Bachelor’s Degree or equivalent relevant work experience. 
• Active/Current National Pharmacy Technician Certification
• Work experience: 3-5 years of relevant work experience in a health plan, TPA or PBM contact center.
• Location information:   Highly qualified remote candidates will be considered provided candidates can adhere to all telecommute requirements (occasional travel may be required)
• Important characteristics of ideal candidate: Detail-oriented, analytical, intellectually curious, good listener, empathetic, ability to challenge status quo, values exemplar
• Specific skills needed for job: Prior experience working with health plan, TPA, or PBM contact center, effective & creative problem-solver, ability to prioritize and manage through change. Solid communication skills.

BENEFITS

• Competitive Compensation
• Full Benefits (Medical, Dental, Vision, Commuter)
• 401K plan
• Company sponsored social events

Rightway is proud to be an Equal Employment Opportunity employer

We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics

Company Description

We're a technology and services company radically simplifying the healthcare experience for clients and members.