PBM Analyst at Rightway

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Full Time

Start Date

Immediate

Expiry Date

15 Jan, 26

Salary

100000.0

Posted On

18 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, Financial Modeling, Microsoft Excel, SQL, Python, Attention to Detail, Communication Skills, Contract Interpretation

Industry

Hospitals and Health Care

Description

ABOUT THE ROLE: Rightway is seeking four dynamic Analysts to join our growing COGS & Underwriting Strategy team. Each hire will support a specialized area — Underwriting, Pricing, COGS, or Rebates — contributing to data-driven strategies that enhance pricing accuracy, client value, and financial performance.This is an exciting opportunity for analytical professionals who thrive on problem-solving, collaboration, and financial modeling. Candidates will be considered for all four roles during the hiring process, and placement will be based on experience, technical skillset, and team alignment. WHAT YOU’LL DO: Depending on preferred placement, you may focus on one or more of the following areas: Underwriting Execute financial and pricing models for client bids and renewals, interpreting results to identify key cost and performance drivers. Present underwriting analyses to internal stakeholders and refine offers to achieve optimal competitiveness. Perform detailed pharmacy claims analysis to identify and remedy variances in financial performance by recommending adjustments to pricing schedules. Conduct studies on novel pricing phenomena and industry trends to support market-leading innovative pricing strategies. Billing, Contracts & Cost of Goods (COGS) Prepare and process client invoices, remittances, and billing files with accuracy and timeliness. Analyze pharmacy claims and administrative fee data to identify trends and ensure compliance with contractual terms. Interpret client contracts to extract billing requirements and flag variances impacting operational accuracy. Collaborate with Finance, Legal, and Operations teams to streamline billing processes and resolve discrepancies. Rebates & Financial Analysis Analyze pharmacy claims and rebate data to identify cost drivers, trends, and performance variances. Evaluate client-level rebate guarantees and forecasting models to support underwriting and renewals. Partner with Clinical and Formulary teams to assess the financial impact of formulary decisions and new drug launches. Support audit and internal control documentation, ensuring rebate data accuracy and transparency. Pricing Strategy & Operations Build and deliver PBM pricing analytics, such as copay modeling, formulary impact reports, and executive dashboards. Conduct studies on industry trends and regulatory changes to inform innovative pricing and market strategies. Maintain and validate critical datasets including drug lists, network data, and rebate or pricing structures. Participate in process improvement initiatives to enhance scalability, efficiency, and data integrity. WHO YOU ARE: Bachelor's degree in Business, Finance, Mathematics, Accounting, or related field 1-2 years of relevant experience in billing, finance underwriting, or data analysis Strong proficiency in Microsoft Excel, including formulas, pivot tables, and data manipulation SQL or Python programming knowledge and experience Excellent attention to detail and accuracy in data entry and analysis Strong written and verbal communication skills Ability to read and interpret contracts and legal documents Experience with database management systems preferred SALARY: $70,000-$100,000/yr Offer amounts for both remote and in office roles are influenced by geographic location. 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 kind as a condition of employment. ABOUT RIGHTWAY: Rightway is 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. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them. Since its founding in 2017, Rightway has raised over $205mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs. HOW WE LIVE OUR VALUES TO OUR TEAMMATES: We’re seeking those with passion for healthcare and relentless devotion to our goal. We need team members that embody our following core values: 1) We are human, first Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding. 2) We redefine what is possible We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems. 3) We debate then commit We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team. 4) We cultivate grit Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity. 5) We seek to delight Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success. Rightway is Proudly an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.

Responsibilities

The Analysts will support specialized areas such as Underwriting, Pricing, COGS, or Rebates, contributing to data-driven strategies that enhance pricing accuracy and financial performance. They will execute financial models, analyze pharmacy claims, and collaborate with various teams to streamline processes and improve outcomes.