Pharmacy Customer Service Representative

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.

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 $200mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with satellite offices in Miami and Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

THE ROLE:

We’re looking for a Pharmacy Customer Service Representative who is motivated by our mission to unlock transformational healthcare outcomes.  To simplify the healthcare experience for employers and members, we have created a single digital platform across medical, pharmacy benefits & virtual care. 

Our pharmacy benefit management (PBM) offering represents an important growth area for Rightway.  Helping clients better manage pharmacy spend to make drugs more affordable for their employees and dependents is critical to their business sustainability.  RightwayRx is responsible for designing, building and operating a new-to-the-world PBM model base on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers

The Pharmacy Customer Service Representative is a member of the RightwayRx Operations team reporting to the Sr Director of PBM Operations. This role works regularly with members and providers to resolve inquiries related to benefits, claim adjudication and utilization management.

 

*Please note this role is full time on-site.*

 

WHAT YOU’LL DO:

• Handles calls and correspondence (electronic and written) regarding pharmacy benefit inquiries from providers (pharmacy/physician) and members.
• Effectively communicate issues and resolution to members and providers.
• Document calls within a call tracking system using established protocols to ensure resolutions are clear, concise, and accurate.
• Assist network pharmacies in processing prescription claims. Review claims for accuracy against benefit guidelines and contract standards.
• Serve as a customer advocate in problem resolution and follow through.
• Creates and supports and environment which fosters teamwork, cooperation, respect and diversity.
• Perform other duties and projects as assigned.

 

WHO YOU ARE:

• Education level: Bachelor’s Degree or equivalent relevant work experience. 
• Active/Current National Pharmacy Technician Certification
• Work experience: 3-5 years of relevant work experience in a health plan, TPA or PBM contact center.
• Important characteristics of ideal candidate: Detail-oriented, analytical, intellectually curious, good listener, empathetic, ability to challenge status quo, values exemplar
• Specific skills needed for job: Prior experience working with health plan, TPA, or PBM contact center, effective & creative problem-solver, ability to prioritize and manage through change. Solid communication skills.

SALARY: $21-24/HR

 

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 following core values:

1) 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.

2) 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.

3) 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.

4) 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.

5) 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.

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Last updated on Aug 15, 2024