Pharmacy Customer Service Representative
Pharmacy Customer Service Representative
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Job Description
ABOUT THE ROLE:
Were looking for a Pharmacy Customer Service Representativewho 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 more affordable for their employees and dependents is critical to their business sustainability. RightwayRx is responsible for designing building and operating a newtotheworld PBM model base on our core tenets: fairness & transparency unlocking the supply chain supporting the physicianpatient 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.
WHAT YOULL 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: Bachelors Degree or equivalent relevant work experience.
- Active/Current National Pharmacy Technician Certification
- Work experience: 35 years of relevant work experience in a health plan TPA or PBM contact center.
- Important characteristics of ideal candidate: Detailoriented 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 problemsolver ability to prioritize and manage through change. Solid communication skills.
SALARY: $2122/HR
Offer amounts for both remote and in office roles are influenced by geographic location
CYBERSECURITY AWARENESS NOTICE
In response to ongoing and industrywide fraudulent recruitment activities (i.e. job scams) Rightway wants to inform potential candidates that we will only contact them from the @ 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
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 patients care journey through a modern mobile app. Rightway is a front door to healthcare giving patients the tools they need along with ondemand 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. Were 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:
Were 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 toand heareach 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 doesnt 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 solutionoriented 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.
Required Experience:
Unclear Seniority
Employment Type
Full Time
