Serve as the primary point of contact for members, providers, and pharmacies across phone, chat, email, and written correspondence.
Field and resolve inquiries related to mail order, benefit design, formulary coverage, medication cost, prior authorization criteria, and claims adjudication.
Support clinical pharmacists with patient and provider outreach, including scheduling appointments, enrolling members in clinical programs, and following up on medication adherence.
Assist network pharmacies in processing prescription claims, reviewing claims for accuracy against benefit guidelines and contract standards.
Accurately document interactions and resolutions within internal systems to support continuity of care, quality assurance, and compliance.
Take ownership of member, provider, and pharmacy issues from initial contact through final resolution.
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About Rightway
Rightway is transforming healthcare by radically simplifying it for clients and members. You will help build innovative Care Navigation and Pharmacy Benefit Management (PBM) platforms. These tools reimagine the member experience, drive industry-leading engagement, and significantly cut total healthcare costs. Since 2017, Rightway has raised over $238 million, serving clients like Tyson Foods and One Medical. They are building a front door to healthcare for over four million members, making care more accessible and affordable.
How We Work
You will join a team that values both intensity and kindness. Rightway operates with core values like being "human, first" and cultivating grit. They believe in open discourse and debate before committing, fostering a culture of mutual understanding. The company encourages redefining what's possible, tackling tough problems with ingenuity. You will work within a flexible environment, with many roles supporting remote work and offering home office stipends.
Engineering at Rightway
You will craft technology that makes healthcare simpler for millions. Rightway uses proprietary machine learning and AI to identify rising-risk members, enabling proactive outreach. Engineers build scalable self-serve analytics dashboards, translating complex healthcare data into intuitive experiences. You will also develop structured platforms to improve implementation tracking and workflow efficiency, solving critical operational bottlenecks. Their modern mobile app guides members to the best care and medications, creating a personalized health journey.
Why Join Us
You will pioneer innovative solutions that radically simplify the complex healthcare system.
You will build and own high-impact products, like the Client Portal, that directly improve customer experience and operational efficiency.
You will contribute to a rapidly growing company, backed by $238M in funding, that actively reduces healthcare costs for millions.
You will work in a flexible, supportive environment where grit, debate, and a human-first approach are core values.
You will use cutting-edge technology including machine learning and AI to deliver data-driven healthcare insights and solutions.
Benefits & Perks
Flexible Spending Account (FSA) and Health Savings Account (HSA)