Rightway
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PBM Analyst
role at
Rightway . This position offers AI‑powered tools and exclusive features to support your career development.
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.
What You’ll Do 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 per year. Offer amounts for both remote and in‑office roles are influenced by geographic location.
Cybersecurity Awareness Notice Rightway will only contact candidates from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits as a condition of employment.
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.
Equal Opportunity Employer Rightway is Proudly an Equal Opportunity Employer. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.
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PBM Analyst
role at
Rightway . This position offers AI‑powered tools and exclusive features to support your career development.
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.
What You’ll Do 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 per year. Offer amounts for both remote and in‑office roles are influenced by geographic location.
Cybersecurity Awareness Notice Rightway will only contact candidates from the @rightwayhealthcare.com email domain. We will never ask for bank details or deposits as a condition of employment.
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.
Equal Opportunity Employer Rightway is Proudly an Equal Opportunity Employer. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.
#J-18808-Ljbffr