Job Opportunities API

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 Specialty Pharmacy Technician / Specialty Pharmacy Guide (CPhT) is a member of the Rightway PBM Clinical Operations team. This role will be key in supporting our Specialty Clinical Pharmacists to deliver on the “pharmacist in the family” approach to engaging our members. We are looking for an experienced certified pharmacy technician to engage with our specialty members in a caring and empathetic manner. Written and verbal communication skills will be critical when interacting with members on the phone, via email, and via the chat function on the Rightway app. A willingness to go the extra mile to provide outstanding customer service is an essential requirement of this role. WHAT YOU’LL DO: Serves as direct member and provider contact for specialty pharmacy benefit information, prior authorization requests, and navigation support.  Inquiries may be received by telephone, chat, fax, email, or written correspondence Prior to the receipt of medication, provides support to members enrolled in specialty management programs, including coordinating any needed prior authorization with the UM team, the fulfillment of the prescription with the specialty pharmacy partner, enrollment in patient assistance programs, and billing questions. After receipt of medication, follow up with members to ensure satisfaction, connect member with a pharmacist for any clinical questions, and coordinate future refills Fields questions from members, human resources departments, pharmacies, and providers related to specialty distribution, benefit design, formulary coverage and cost of medication, prior authorization criteria, claims adjudication, copay/patient assistance, and ensures individual’s questions and issues are resolved Supports Specialty Clinical Pharmacists in patient and provider outreaches, including scheduling of appointments between members and pharmacists, enrollment of members into copay or patient assistance programs, medication adherence support, and other administrative tasks Assists in ensuring all operating and productivity standards are met, which may include conducting quality reviews of calls, chats, and documentation notes to identify opportunities for improvement Ensures regulatory and privacy standards are consistently met Provide support to other teams within Clinical Operations, such as utilization management and navigation WHO YOU ARE: Associate’s or Bachelor’s degree preferred 1-2 year’s experience in a pharmacy technician role within a Specialty pharmacy, PBM, pharmacy department of a health plan, or similar managed care setting.   Active Certified Pharmacy Technician (CPhT) Detail-oriented, adaptable, critical thinker, empathetic, ability to dig deep in understanding an issue to get to true root cause and resolution, desire to improve a patient’s healthcare experience and provide concierge level service. Knowledge of pharmacy claims adjudication and benefit designs/terminology, ability to multi-task and prioritize work, ability to work independently. EXTRA CREDIT: Bi-lingual preferred (Spanish) COMPENSATION: $22.00 - $23.00 /hr Compensation offered will be determined by geographic location, experience, and qualifications. 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 ki