Pharmacy Network Operations Specialist

Rightway; United States; On-site; USD 70,000 - 91,000; Full time

Job summary

Rightway is seeking a Pharmacy Network Coordinator to manage retail, mail-order, and specialty pharmacy networks in the United States. You will keep network data accurate, coordinate onboarding and credentialing, and work cross-functionally with claims, client success, and clinical teams to ensure members have reliable access to the pharmacies they need.

You will audit directories and records, resolve claims and enrollment issues, and develop ad hoc network reports for clients.

Qualifications

• 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 data across multiple systems.
• Excellent written and verbal communication with a service-first approach to pharmacy partners.
• Proven track record in fast-paced environments, managing multiple priorities and driving outreach to providers.
• Intermediate proficiency in Word, Excel or Google Sheets; PBM or claims platforms a plus.

Responsibilities

• Maintains and audits pharmacy network directories, contracts, and credentialing records for accuracy and compliance.
• Coordinates onboarding, terminations, and status changes for retail, mail-order, and specialty pharmacies.
• Serves as day-to-day contact for network pharmacies, resolving claims, enrollment, and access issues.
• Partners with the claims and clinical teams to troubleshoot 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.

Skills

Pharmacy benefits experience

PBM operations knowledge

Network management

Data handling & accuracy

Communication skills

Tools

NCPDP database

Claims platforms

Job description

Rightway is seeking a Pharmacy Network Coordinator to manage retail, mail-order, and specialty pharmacy networks in the United States. You will keep network data accurate, coordinate onboarding and credentialing, and work cross-functionally with claims, client success, and clinical teams to ensure members have reliable access to the pharmacies they need.

You will audit directories and records, resolve claims and enrollment issues, and develop ad hoc network reports for clients.