Pharmacy Navigation Specialist

4 weeks ago


Denver, Colorado, United States Rightway Inc Full time
About the Role:

This position provides critical support to our Pharmacy Navigation team as we scale with new memberships. The successful candidate will play a key role in assisting our Clinical Pharmacists in delivering exceptional patient care and engagement.

Key responsibilities include serving as a direct point of contact for pharmacy benefit information, prior authorization requests, and navigation support. The ideal candidate will have excellent communication skills, be detail-oriented, and possess a strong understanding of pharmacy claims adjudication and benefit designs.

Key Responsibilities:

• Serve as a direct point of contact for pharmacy benefit information, prior authorization requests, and navigation support
• Field questions from members, human resources departments, pharmacies, and providers related to mail order, benefit design, formulary coverage, and cost of medication
• Support Clinical Pharmacists in patient and provider outreaches, including scheduling of appointments between members and pharmacists, enrollment of members into Rightway clinical programs, medication adherence support, and other administrative tasks
• Assist 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

Requirements:

• Associate's or Bachelor's degree preferred
• 1-2 years' experience in a pharmacy technician role within a 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
• Knowledge of pharmacy claims adjudication and benefit designs/terminology, ability to multi-task and prioritize work, ability to work independently

About Rightway:

Rightway is a healthcare company 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. We're seeking a talented Pharmacy Navigation Specialist to join our team and help us deliver exceptional patient care and engagement.

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