The Benefit Specialist sources and maintains up-to-date healthcare benefit information to support Health Guides and members. They are responsible for conducting quality audits, managing content systems, and explaining financial responsibilities like deductibles to members.
Rightway
18 Remote Job Openings at Rightway
Lead daily accounting operations including payables, billing, payroll, and general ledger reconciliations. Support monthly, quarterly, and year-end close processes while contributing to financial statements and audit preparations.
Lead the Application and Cloud Security functions to raise the security maturity of AWS systems and services. Architect defensive controls for AI/LLM capabilities and establish secure engineering patterns across the organization.
Lead end-to-end client implementations for PBM and Navigation service lines from kickoff to steady-state transition. Coordinate cross-functional teams and manage client expectations while incorporating AI tools into operational workflows.
Manage day-to-day operational relationships for PBM clients, including resolving escalations and conducting business reviews. Coordinate with implementation and internal operations teams to ensure seamless onboarding and contractual delivery.
Oversee multiple client implementations and coordinate internal operational functions to transition clients from implementation to maintenance. Serve as the primary point of contact for clients while managing project plans, risk assessments, and business requirements.
Oversee multiple client implementations and coordinate internal operational functions to transition clients from implementation to maintenance state. Serve as the primary point of contact for clients while managing project plans, risk assessments, and business requirements.
Own and evolve the vision for the digital pharmacy experience, focusing on member engagement and outcomes across web and mobile apps. Lead the development of features like drug search and cost transparency while mentoring an Associate Product Manager.
Lead a team of embedded analysts across PBM functions to deliver actionable insights and scalable data products. Partner with business leaders to align analytics workstreams with operational excellence and client success goals.
The VP of Strategic Partnerships will lead the development and execution of partnership strategies to drive business growth and manage high-value industry relationships. This role involves mentoring a high-performing team, overseeing deal lifecycles, and collaborating with executive leadership to align initiatives with corporate objectives.
You will design and build core components for a next-generation claims adjudication platform, including eligibility engines and pricing calculators. Additionally, you will provide technical leadership by mentoring engineers, establishing coding standards, and driving AI-native development workflows.
The Senior Manager will lead clinical consulting services and drive initiatives to improve pharmacy benefit plan performance. They will act as a subject matter expert, collaborating with internal teams and clients to enhance clinical outcomes and cost efficiency.
This role involves continuing to build and iterate on the specialty pharmacy strategy, leading a hybrid team, and managing current specialty programs like clinical management and supply chain optimization. The director will also develop future strategic programs, create SOPs, and leverage technology to enhance operations and member experience.
The role involves leading, coaching, and growing an engineering team focused on building modern web and backend systems while driving the delivery of high-quality, reliable software. This includes partnering with Product and Design to shape roadmaps, providing technical guidance, and promoting strong engineering practices.
The engineer will pioneer AI-driven solutions to enhance care navigation and PBM services, leading rapid prototyping cycles to transform concepts into production features quickly. They will also architect and implement full-stack solutions using the modern tech stack while driving technical decisions independently.
This role involves leading the Client Success team within the Pharmacy Benefit Management (PBM) line of business, focusing on client retention, satisfaction, and business growth. Key duties include developing PBM-specific CS strategy, optimizing operations, creating best practices, and serving as an escalation point for complex client issues.
The role involves designing, developing, and maintaining scalable data models, primarily using dbt, to power a Financial Risk Engine by integrating claims, contract, pricing, and utilization data within the Unified Data Warehouse (UDW). This engineer will also partner with finance and operations teams to translate complex financial structures into transparent, auditable data models and build curated data marts for self-service analysis.
The role involves owning the product vision and roadmap for Clinical Risk & Engagement, defining the end-to-end workflow from risk forecast to action, and building initial monitoring and risk identification systems within the first six months. Key duties include creating actionable clinical insights, partnering with clinical teams on outreach workflows, and defining the data models that power these products.
