Job Description

ABOUT RIGHTWAY:

Rightway is the leader in driving healthcare value for everyone, everywhere through smart clinical navigation, best-in-class technology, and the lightest lift client experience.

Rightway’s care navigation and new-to-the-world PBM platforms have revolutionized the way members traverse the confusing healthcare landscape. With us, employers can provide employees and their families with the education, navigation, and advocacy they need to be better healthcare consumers. We simplify the healthcare journey and guide members to the highest quality care and medication, leading to better care and happier people at lower cost.

Started in 2017, Rightway is rapidly growing and has raised over $130mm to date from investors including Khosla Ventures, Thrive Capital, Tiger Global, and others. We are headquartered in New York City, with satellite offices in Miami and Denver. Empowered by a talented team of medical experts, pharmacists, entrepreneurs, tech experts, engineers, and strategists, we’re making our vision of radically simplifying healthcare, a reality.

ROLE:

We’re looking for a Pharmacy Customer Service Representative who is motivated by our mission to unlock transformational healthcare outcomes. To simplify the healthcare experience for employers and members, we have created a single digital platform across medical, pharmacy benefits & virtual care.

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

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.

SEEKING CANDIDATES FOR ALL SHIFT SCHEDULES INCLUDING OVERNIGHT.

WHAT YOU’LL DO:

• 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.

WHO YOU ARE:

• 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.

HOW WE LIVE OUR VALUES TO OUR TEAMMATES:

We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members who will:

• Paint the back of the fence

We look for people that take pride in producing excellent work – whether or not it’s seen. We empower each employee to operate with an “ownership” mentality and trust that they will produce exceptional results.

• Execute with empathy

We practice compassionate empathy in every interaction. Our team is focused on humanizing the healthcare experience and treats our workplace no differently.

• Struggle once to solve twice

We value ingenuity. We encourage our team to think about scalable solutions that will allow Rightway to execute well today and even better tomorrow.

• Compound your pennies

We recognize that small decisions can drive outsized returns. We love when our team makes impactful, incremental advances, especially if they believe it will drive a million-dollar return.

• It’s a great day for a great day

We remind ourselves each and every day that we’re fortunate to be changing the healthcare system for the better. We view it as a duty to perform our roles with unbounded optimism and best-in-class execution, given how lucky we are.

Rightway is a healthcare company looking to improve healthcare outcomes for everyone, everywhere. With that in mind, we have to consider what is good for the health of our team, the company, and the communities we operate in. As such, Rightway has determined a mandatory COVID-19 vaccination policy for all employees, in combination with other safety precautions, is the best way forward.

Rightway is PROUDLY an Equal Opportunity Employer that believes in ‘strength in the diversity of thought processes, beliefs, background and education’ and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.

Company Description

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