Pharmacy Network Coordinator
Core
Manages Rightway's retail, mail-order, and specialty pharmacy networks by maintaining data accuracy, coordinating onboarding/credentialing, and resolving access issues for members.
Role type
Pharmacy Network Coordinator
Builds
Reliable pharmacy network access and data integrity for Rightway's members and clients
Domain
Healthcare / Pharmacy Benefit Management (PBM)
Deliverable
Dashboards & analysis
Required skills
Pharmacy network contracting, credentialing, claims adjudication, data auditing, compliance verification, stakeholder communication, process improvement
Preferred skills
PBM regulatory knowledge, direct pharmacy partner experience, PTCB certification
Technologies
NCPDP database, OIG, GSA, SAM, Word, Excel, Google Sheets, PBM platforms
Responsibilities
Maintain and audit pharmacy network directories, contracts, and credentialing records; Coordinate onboarding, terminations, and status changes for pharmacies; Serve as point of contact for network pharmacies to resolve access issues; Partner with claims and clinical teams to troubleshoot adjudication and payment issues; Develop ad hoc network reports for clients; Document and improve network operations processes