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 focuses on the day-to-day inquiries and operations related to benefit configuration and administration, specifically benefit plan setup.

Responsibilities

• 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, including 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, as well as tracking 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 all documentation regarding benefit plan setups, formulary configurations, and implementations is current and accurate.

Requirements

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

Pay

$23.00 - $27.00/hr. Compensation offered will be determined by geographic location, experience, and qualifications.

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 who answer questions and manage the frustrating parts of healthcare.

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:
  • 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 honor our stories, listen to—and hear—each other, celebrate our differences and similarities, and strive for mutual understanding.
  • We redefine what is possible: We look beyond obstacles to imagine new solutions, using ingenuity and resourcefulness when faced with tough problems.
  • We debate then commit: We believe in open discourse and appreciate different perspectives. We challenge assumptions, approach discussions with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.
  • We cultivate grit: We reflect and learn from challenges, embracing failure as a stepping stone to future success. We act with guts, resilience, initiative, and tenacity.
  • We seek to delight: We work tirelessly to meet client goals while delivering the best experience to our members. We are kind, respectful, and solution-oriented, holding ourselves accountable to our clients and 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. All employment decisions are based on merit, qualifications, need, and performance.