Job Overview
Location
Remote
Job Type
Full-time
Category
HR & Recruiting
Date Posted
April 14, 2026
Full Job Description
đź“‹ Description
- • The Clinical Pharmacist, Utilization Management role supports Rightway Healthcare’s mission to make drugs more affordable by managing pharmacy spend through clinically appropriate and cost-effective utilization management (UM) decisions. This role is critical to delivering on Rightway’s innovative PBM model built on fairness, transparency, and patient empowerment.
- • Day-to-day responsibilities include reviewing UM requests for coverage, ensuring compliance with state and federal guidelines, coordinating with pharmacy technicians, pharmacists, and medical directors, discussing clinical strategies with prescribers, participating in quality reviews, and supporting the development of clinical policies such as Prior Authorization, Step Therapy, and Quantity Limit programs.
- • The role is part of Rightway’s PBM Clinical Operations team, which is central to the company’s growth in pharmacy benefit management. Rightway is a mission-driven healthcare technology company founded in 2017, headquartered in NYC with offices in Denver and Dallas, and backed by over $205M from top-tier investors like Khosla Ventures and Tiger Global.
- • The Clinical Pharmacist will deepen expertise in managed care pharmacy, influence clinical policy development, collaborate across teams without direct authority, and contribute to improving patient outcomes and client savings through evidence-based UM practices.
🎯 Requirements
- • PharmD degree required (PharmD preferred)
- • Active pharmacist license in good standing in state of residence, with willingness to obtain licensure in additional states as needed
- • 1+ year of experience coordinating medication selection with prescribers and care teams; 1–3+ years of managed care (PBM or health plan) prior authorization experience preferred
🏖️ Benefits
- • Base salary range of $120,000–$125,000
- • Remote work flexibility with core hours Monday–Friday, 10am–6pm EST
- • Opportunity to shape innovative PBM models grounded in fairness, transparency, and patient navigation
Skills & Technologies
About Rightway Healthcare, Inc.
Rightway Healthcare provides a healthcare navigation and pharmacy benefit platform that combines clinical guidance with transparent pricing to lower employer healthcare costs. Its mobile and web tools connect members to dedicated clinicians and pharmacists who steer them to high-value providers, optimize prescriptions, and resolve claims issues. The company integrates with existing health plans, replacing traditional PBMs and navigation vendors. Founded in 2017, Rightway serves self-insured employers and health plans across the United States, aiming to improve outcomes and reduce spending through data-driven, human-led care navigation.
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