Pharmacy Network Coordinator

ABOUT THE ROLE:

The Pharmacy Network Coordinator supports the day-to-day management of Rightway's retail, mail-order, and specialty pharmacy networks. This person keeps network data accurate, coordinates pharmacy onboarding and credentialing, and works cross-functionally with claims, client success, and clinical teams to make sure members always have reliable access to the pharmacies they need.

WHAT YOU’LL DO:

Maintains and audits pharmacy network directories, contracts, and credentialing records for accuracy and compliance.  This includes obtaining applicable licenses and certificates of insurance from pharmacies, as well as verifying eligibility through the NCPDP database and federal and state sources (e.g., OIG, GSA, SAM).

Coordinates onboarding, terminations, and status changes for retail, mail-order, and specialty pharmacies.

Serves as a day-to-day point of contact for network pharmacies, resolving claims, enrollment, and access issues.

Partners with the claims and clinical teams to troubleshoot pharmacy-level adjudication and payment issues.

Supports the benefit and navigation team with network-related issues.

Develops and delivers ad hoc network reports for clients.

Helps document and continuously improve network operations processes.

WHO YOU ARE:

2+ years of experience in pharmacy benefits, PBM operations, network management, or a related healthcare role.

Working knowledge of pharmacy network contracting, credentialing, or claims adjudication.

Ability to work independently, with strong attention to detail and comfort managing data across multiple systems.

Excellent written and verbal communication skills, with a service-first approach to pharmacy partners.

Proven track record in fast-paced environments, managing multiple priorities simultaneously and bringing the initiative and persistence needed to drive outreach to pharmacy providers and close out contracts and tasks.

Intermediate Proficiency in Word, Excel or Google Sheets; experience with PBM or claims platforms is a plus.

EXTRA CREDIT:

Familiarity with PBM regulatory and network adequacy requirements.

Background working directly with retail, mail-order, or specialty pharmacies.

PTCB certification (or state license).

COMPENSATION:  $70,000 - $91,000 annually, in addition to bonus and equity

Compensation offered will be determined by geographic location, experience, and qualifications.