Jobs at Rightway

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.

Own client-facing technical implementation and support across SSO, file transformations, provider networks, engagement platforms, and eligibility workflows. Configure and validate systems, monitor file ingestion, investigate registration and data-quality issues, resolve standard problems, and coordinate escalations with engineering teams. Maintain implementation records, SOPs, knowledge bases, and QA checklists while partnering with Client Success, Implementation, Data Engineering, and Product to improve tooling and processes.

Manages day-to-day pharmacy benefit configuration and administration, including plan setup, copay structures, formulary schedules, coverage rules, reporting, troubleshooting, documentation, and issue resolution. Serves as the primary contact for benefit configuration inquiries and collaborates with account management, contact center, and clinical teams. Supports pharmacy associates with benefit updates, formulary maintenance, and complex configuration issues. PBM experience in benefits administration or plan configuration is required.

Manage key client relationships in the Pharmacy Benefit Management sector, ensuring high-quality service delivery and client satisfaction while coordinating with internal teams and leading client interactions.

Support day-to-day PBM data operations including eligibility, accumulator, and claims extract file feeds. Monitor and troubleshoot file feeds and third‑party integrations, collaborate with engineering and client teams, maintain documentation and internal controls, and assist during peak seasons to ensure timely, accurate data delivery.

Serve as a subject-matter expert for Rightway's Navigation and Unity solutions during client engagements. Support RFPs, pitches, demos, workshops, and enablement; translate client needs into actionable solutions; collaborate across product, delivery, marketing, and sales to drive implementation, optimization, and commercial outcomes.

Sell Rightways PBM and Navigation solutions to large, self-funded Fortune 500 employers in the Eastern U.S. Build pipeline, close deals, manage RFP-to-contract process, and coordinate cross-functional teams to onboard clients. Represent the company at industry events and use Salesforce to track sales activities.

Lead design and productionalization of AI-driven features for care navigation and PBM. Rapidly prototype and ship full-stack solutions using Node.js, React, TypeScript, Ruby, GraphQL, and Postgres. Architect scalable, secure systems for sensitive healthcare data, set AI integration standards, drive technical decisions, and mentor engineers to ensure production-quality implementations.