PBM Operations Analyst
Confirmed live in the last 24 hours

201-500 employees

Healthcare experience simplification through technology and services
Company Overview
Rightway stands out as a leader in the healthcare industry by leveraging technology to simplify healthcare experiences for clients and members. Their competitive advantage lies in their ability to streamline complex processes, making healthcare more accessible and user-friendly. The company's culture fosters continuous learning and improvement, encouraging employees to contribute to technical advancements and industry leadership.

Company Stage

Series C

Total Funding





New York, New York

Growth & Insights

6 month growth


1 year growth


2 year growth

Experience Level
Operations & Logistics
  • Bachelor's degree preferred. Relevant experience considered for exceptional candidates
  • Pharmacy Technician or related experience highly desirable
  • 1-3 years of PBM experience in claims or benefit configuration
  • 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 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
  • Support the execution of all eligibility and accumulator operations and interfaces from implementation through ongoing operations and maintenance
  • Serve as day-to-day contact for all eligibility and accumulator needs
  • Collaborates with technology, account management, benefit administration, and other internal stakeholders to ensure that eligibility and accumulator functions are implemented and operating in accordance with requirements
  • Oversee all downstream vendor feeds (i.e. ID card fulfillment), third party integrations (i.e. health plans, TPAs) and ensures all deliverables are met timely and troubleshoots issues
  • Configures benefits into the claim adjudication platform, including benefit inclusions/exclusions copay, accumulator, and other benefit parameters
  • Develops and executes on test scenarios to ensure accuracy of benefit setup both at initial setup and conducts ongoing monitoring and regression testing. Works to correct all identified defects
  • Performs research and troubleshoots inquiries or issues related to claims adjudication, accumulators, and eligibility
  • Ensures all documentation regarding setup and internal controls is always up to date