ABOUT THE ROLE:
Our PBM goal is to help clients better manage pharmacy spend to make drugs more affordable for their employees and dependents. Rightway is responsible for designing, building, and operating a new-to-the-world PBM model based on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers
The Specialty Pharmacy Technician / Specialty Pharmacy Guide (CPhT) is a member of the Rightway PBM Clinical Operations team. This role will be key in supporting our Specialty Clinical Pharmacists to deliver on the “pharmacist in the family” approach to engaging our members. We are looking for an experienced certified pharmacy technician to engage with our specialty members in a caring and empathetic manner. Written and verbal communication skills will be critical when interacting with members on the phone, via email, and via the chat function on the Rightway app. A willingness to go the extra mile to provide outstanding customer service is an essential requirement of this role.
WHAT YOU’LL DO:
- Serves as direct member and provider contact for specialty pharmacy benefit information, prior authorization requests, and navigation support. Inquiries may be received by telephone, chat, fax, email, or written correspondence
- Prior to the receipt of medication, provides support to members enrolled in specialty management programs, including coordinating any needed prior authorization with the UM team, the fulfillment of the prescription with the specialty pharmacy partner, enrollment in patient assistance programs, and billing questions. After receipt of medication, follow up with members to ensure satisfaction, connect member with a pharmacist for any clinical questions, and coordinate future refills
- Fields questions from members, human resources departments, pharmacies, and providers related to specialty distribution, benefit design, formulary coverage and cost of medication, prior authorization criteria, claims adjudication, copay/patient assistance, and ensures individual’s questions and issues are resolved
- Supports Specialty Clinical Pharmacists in patient and provider outreaches, including scheduling of appointments between members and pharmacists, enrollment of members into copay or patient assistance programs, medication adherence support, and other administrative tasks
- Assists in ensuring all operating and productivity standards are met, which may include conducting quality reviews of calls, chats, and documentation notes to identify opportunities for improvement
- Ensures regulatory and privacy standards are consistently met
- Provide support to other teams within Clinical Operations, such as utilization management and navigation
WHO YOU ARE:
- Associate’s or Bachelor’s degree preferred
- 1-2 year’s experience in a pharmacy technician role within a Specialty pharmacy, PBM, pharmacy department of a health plan, or similar managed care setting.
- Active Certified Pharmacy Technician (CPhT)
- Detail-oriented, adaptable, critical thinker, empathetic, ability to dig deep in understanding an issue to get to true root cause and resolution, desire to improve a patient’s healthcare experience and provide concierge level service.
- Knowledge of pharmacy claims adjudication and benefit designs/terminology, ability to multi-task and prioritize work, ability to work independently.
EXTRA CREDIT:
Bi-lingual preferred (Spanish)
BASE SALARY: $22-23/hr
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. If you have any questions about a suspicious interaction with Rightway, please feel free to reach out to us at ** Redacted **.
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 $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with a satellite office in Denver. 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 who will:
- 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.
- 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.
- 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.
- 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.
- 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 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.