Rightway Benefits Overview

Configures and maintains pharmacy benefit plans and claims adjudication rules for client implementations and plan changes. Reviews benefit documentation, develops and executes test claims, performs regression testing, investigates defects, and resolves adjudication inquiries. Maintains audit-ready documentation and tracks implementation milestones while collaborating with implementation, client success, product, and formulary teams.

Lead architecture and delivery across Rails backends and React frontends, build Node.js and NestJS platform integrations, establish testing and code-quality standards, mentor engineers, review code, and improve reliability, performance, and developer experience. The role requires technical ownership across multiple backend technologies and leadership in AI-assisted development practices.

Leads the full lifecycle of pharmacy benefit management agreements, including drafting, negotiation, redlines, execution, amendments, renewals, and RFP responses. Structures financial, clinical, pricing, performance, and service terms while partnering with legal, finance, underwriting, clinical, operations, sales, and client success teams. Maintains contract templates and clause libraries, manages obligations and deadlines, and escalates legal, financial, and regulatory risks.