Pharmacy Implementation Manager

At Rightway we are committed to creating a diverse environment and are proud to be an equal opportunity employer. We hire the best talent and actively seek diversity of thought processes, beliefs, background, and education. Rightway fosters an inclusive culture where differences are celebrated to drive the best business decisions possible.
We are committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.
Rightway was founded in early 2017 by a team of dedicated healthcare, business and technology leaders. Rightway is a technology platform that provides employees and their families with the support, information, and advocacy they need to be better healthcare... consumers. We combine a high-tech consumer portal with a high-touch dedicated concierge environment to provide consumers with the same level of support and guidance they would receive if they had a doctor in the family. We are focused on personalization, implementation, advocacy and results.
Rightway works with employers from 100 – 25,000 employees to provide an ecosystem of healthcare navigation for employees. We are committed to generating high member satisfaction scores, industry-leading engagement and a quantifiable ROI for every employer. Our approach is rooted in analytics and guided by a bottom-up understanding of a population.
Rightway is privately financed, raising over $100mm to date from investors such as Thrive Capital.
It is headquartered out of New York City, with new offices in Hudson Yards. We also have remote offices in Miami, FL, and San Francisco, CA.
RESPONSIBILITIES
Leads new client TPA/employer group implementation process, including leading client/consultant meetings and gathering/documenting requirements for internal and external teams.
Manages internal strategic projects, including leading internal/vendor stakeholder meetings to gather/document requirements, maintain project plans, track tasks, track risks/issues, and create status reports for various internal and external audiences.
Has working knowledge of Pharmacy Benefit Management industry terminology, including benefit design options, pharmacy claims adjudication rules, and PBM operations.
Reviews client RFPs and contracts to ensure all commitments are incorporated into the project scope.
Ability to manage concurrent client implementations.
Identifies project risks and develops mitigation plans.
Coordinates configuration testing and interprets results for accuracy.
Manages member transition disruption with internal and external stakeholders. Partners with client team to develop and execute a member and provider communication plan.
Ensures operational and technology readiness for go-live by coordinating with internal and external stakeholders.
Monitors go-live claim and operational activity to identify any potential issues and develops rapid response plans to implement solutions and remediation efforts.
Develops and maintains standard operating procedures and supports training for new team members.
Ensures regulatory and privacy standards are consistently met.

REQUIREMENTS

Education level: Bachelor’s degree required, CPhT certification a plus
Work experience: 3 years’ experience as an implementation manager or similar project management and client-facing role within a PBM or pharmacy department of a health plan.
Location information: Remote. Looking for highly qualified candidates with demonstrated ability to work in remote environments. May require occasional travel to Miami, Denver or New York City offices.
Core working hours are weekdays between 8am and 6pm ET, but nature of the role will require weekend and holiday hours during client go-live dates
Important characteristics of ideal candidate: Detail-oriented, critical thinker, client management skills, ability to dig deep in understanding an issue to get to true root cause and resolution, desire to improve the client and member experience during a PBM transition, ability to connect the dots across various departments and processes to identify implications of requirements or issues to other areas of the company. Willingness to refine/iterate the process.
Specific skills needed for the job: Knowledge of pharmacy claims adjudication and benefit designs/terminology, project management experience, ability to multitask and prioritize work, ability to work reasonably independently, presentation and communication skills (written and verbal), ability to perform intermediate data analysis.
BENEFITS
Competitive Compensation
Full Benefits (Medical, Dental, Vision, Commuter, HSA, Wellness Programs, etc.)
401K plan
Company-sponsored social events
Rightway is proud to be an Equal Employment Opportunity employer
We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics