About the Role

Our PBM goal is to help clients better manage pharmacy spend to make drugs more affordable for their employees and dependents. Rightway is responsible for designing, building, and operating a new-to-the-world PBM model based on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers

The Clinical Pharmacist, Formulary Management is a member of the RightwayRx Operations team. This role will assist leadership in delivering on our formulary strategy and actively manage our formularies, including clinical and financial performance.

WHAT YOU'LL DO: 

• Support all lines of business via developing formularies that are clinically appropriate and cost effective, including prior authorization, step therapy, and quantity limits
• Maintain our formularies in our formulary database (MMIT)
• Coordinate coding and testing of our formularies in our claims platform
• Analyze the formularies for cost savings opportunities, including rebates and available patient assistance programs
• Supports P&T process including the development of therapeutic class/drug monographs as needed
• Research and develop therapy-specific clinical policies and utilization management programs such as Prior Authorization, Step Therapy, Quantity Limit, and/or Coverage Determination programs
• Support utilization management team with clinical reviews and coordination with prescribers
• Support Clinical Operations leadership and coordinate with Pharmacy Navigation team as needed

Who You Are

• Pharmacy Degree Required.  Preferred: PharmD
• 3+ years of managed care (PBM or health plan) formulary management experience with 2+ years of Medicare experience
• Pharmacist license in good standing in state of residence.  Willingness to achieve and maintain licensure in multiple states (if needed)
• Remote/Work from home/Virtual with some required travel to New York City or other office locations
• Detail-oriented, intellectually and clinically curious, good listener, empathetic, ability to challenge status quo, values exemplar
• Great pharmacy benefit knowledge, expert-level Microsoft Excel skills, effective & creative problem-solver, ability to prioritize and manage through change.
• Solid communication skills, ability to lead projects and influence others even without direct reporting line ownership

SALARY RANGE: $120,000-$130,000

About Us

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 $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re 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:

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 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.