Pharmacy Network Coordinator

Job not on LinkedIn

🔥 2 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $70k - $91k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

💊 Pharmacist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Rightway

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

💰 $100M Series C on 2021-03

Healthcare • Healthcare Insurance • SaaS

Rightway is a healthcare company focused on providing care navigation and pharmacy benefits management solutions. It specializes in helping employers and health systems lower healthcare costs and improve outcomes through personalized, proactive clinical support and transparent pharmacy benefits management. Rightway offers a human-first approach, providing real-time, one-on-one support to members to help them make better healthcare decisions and navigate the complexities of healthcare systems. The company aims to reduce healthcare costs while improving employee satisfaction with healthcare services.

📋 Description

• Maintains and audits pharmacy network directories, contracts, and credentialing records for accuracy and compliance • Obtains applicable licenses and certificates of insurance from pharmacies • Verifies eligibility through the NCPDP database and federal and state sources, including OIG, GSA, and SAM • Coordinates onboarding, terminations, and status changes for retail, mail-order, and specialty pharmacies • Serves as a day-to-day point of contact for network pharmacies, resolving claims, enrollment, and access issues • Partners with claims and clinical teams to troubleshoot pharmacy-level adjudication and payment issues • Supports the benefit and navigation team with network-related issues • Develops and delivers ad hoc network reports for clients • Helps document and continuously improve network operations processes

🎯 Requirements

• 2+ years of experience in pharmacy benefits, PBM operations, network management, or a related healthcare role • Working knowledge of pharmacy network contracting, credentialing, or claims adjudication • Ability to work independently, with strong attention to detail and comfort managing data across multiple systems • Excellent written and verbal communication skills, with a service-first approach to pharmacy partners • Proven track record in fast-paced environments, managing multiple priorities simultaneously and bringing the initiative and persistence needed to drive outreach to pharmacy providers and close out contracts and tasks • Intermediate Proficiency in Word, Excel or Google Sheets; experience with PBM or claims platforms is a plus • Familiarity with PBM regulatory and network adequacy requirements • Background working directly with retail, mail-order, or specialty pharmacies • PTCB certification (or state license)

🏖️ Benefits

• Bonus • Equity