PBM Coordinator, Benefit Configuration

ABOUT THE ROLE:

The PBM Benefits Coordinator is a member of the Rightway Operations team reporting to the Manager of Benefit Configuration. This role will be responsible for the day-to-day inquiries and operations related to benefit configuration and administration, specifically focusing on benefit plan setup.

WHAT YOU’LL DO:

• Primary Contact: Serve as the main point of contact for all internal inquiries related to benefit configuration, formulary management, and plan setup, ensuring timely and accurate resolution.
• Troubleshooting: Research and troubleshoot inquiries or issues related to benefit configurations and formulary setups. This includes reviewing benefit plan documents and formulary files to identify and resolve discrepancies.
• Benefit Management: Configure and maintain benefit plans, copay structures, and formulary schedules; update benefit parameters and coverage rules as needed.
• Reporting: Generate and analyze benefit utilization reports and formulary compliance metrics to monitor plan performance and ensure accurate benefit administration.
• Collaboration: Work closely with various departments, including Account Management, the Contact Center, and the Clinical Team, to resolve benefit-specific issues and address or escalate broader client concerns.
• Assistance: Support the PBM Pharmacy Associate with daily benefit configuration tasks and formulary maintenance. Also support daily tracking of benefit plan updates and formulary changes.
• Complex Issue Resolution: Partner with the PBM Pharmacy Associate to address and resolve complex benefit configuration and formulary-related issues.
• Documentation: Ensure that all documentation regarding benefit plan setups, formulary configurations, and implementations is current and accurate.

WHO YOU ARE:

• Pharmacy Technician or related experience highly desirable
• 1-3 years of PBM experience in benefits administration or plan configuration

COMPENSATION: $23.00 - $27.00/hr

Compensation offered will be determined by geographic location, experience, and qualifications.

CYBERSECURITY AWARENESS NOTICE

In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment. 

ABOUT RIGHTWAY:

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide patients to the best care and medications by inserting clinicians and pharmacists into a patient’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them.

Since its founding in 2017, Rightway has raised over $200mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

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 that embody our core values:

1) We are human, first
Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.

2) We redefine what is possible
We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3) We debate then commit
We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.

4) We cultivate grit
Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.

5) We seek to delight
Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.

Rightway is proud to be an Equal Opportunity Employer that believes in the strength of diverse thought, beliefs, backgrounds, and education. We foster an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis protected by applicable law. All employment decisions are based on merit, qualifications, need, and performance.