PBM Operations Associate
Rightway
WorldwideFully remoteFull TimeJuniorHealthcare & Telemedicine
No salary statedPosted 4 hours ago4h agoApply link checked 2 hours ago
Why we think you can apply
- Hiring model
- Open worldwide · the employer states no country restriction
- Work from
- Anywhere, the UAE included
Posted 4 hours ago · apply link checked 2 hours ago
About the role
Responsibilities
- Review client benefit design documentation for completeness and accuracy
- Configure client benefit designs in the claims adjudication platform, including plan parameters and copay structures
- Develop and execute test claim scenarios to validate benefit setup and perform regression testing
- Research and resolve inquiries related to claims adjudication and benefit configuration
- Partner cross-functionally with product, client success, implementation, and formulary teams
- Maintain audit-ready documentation of benefit setup and internal controls
- Track work across implementation and plan change trackers
Requirements
- 1-3 years of PBM experience in claims adjudication, benefit configuration, or testing/QA
- Bachelor's degree preferred; relevant experience considered
- Pharmacy Technician certification or related pharmacy experience highly desirable
- Strong attention to detail and ability to trace claim outcomes to configuration drivers
- Ability to navigate ambiguity and work from incomplete requirements
- Proficiency with Excel, Smartsheet, and claims platforms
About the Company
Rightway is on a mission to harmonize healthcare for everyone, everywhere. Their 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.
What we look for
- Bachelor's degree preferred
- 1-3 years PBM experience
- Claims adjudication experience
- Benefit configuration experience
- Testing/QA experience
- Pharmacy Technician certification preferred
- Proficiency in Excel and Smartsheet
ExcelQuality AssuranceSmartsheetPBMClaims adjudication
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Rightway
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NeverApply scores every new listing against your CV, salary floor and visa. A handful of real matches by morning.
Get your daily matchesPBM Operations AssociateRightway · 3 free applies a month