CareerRiver

Clinical, Formulary Management Pharmacist

rightwayhealthcare · Remote

📍 Remote💰 $120,000 - $130,000via greenhousePosted 2026-07-15
Apply on company site ↗
CareerRiver pulls this listing straight from the employer's hiring system — no recruiter middleman, no reposts. Applying takes you directly to rightwayhealthcare.
ABOUT THE ROLE: We are seeking a Pharmacist, Formulary & Clinical Strategy to join Rightway's growing Clinical Strategy team. This is an early-career role designed for a clinical pharmacist who is ready to apply their managed care expertise in a technology-forward, fast-paced environment. You will support the design, maintenance, and optimization of Rightway's formularies and prior authorization (PA) criteria, while also contributing to data-informed recommendations that shape our clinical strategy. Critically, this role is for someone who is not just comfortable with AI tools — but actively uses them to work smarter, move faster, and surface better insights. This role reports to the leader of Clinical Strategy and works cross-functionally with Product, Data & Insights, Cost of Goods, and Client Operations. WHAT YOU’LL DO: Data Interpretation & Clinical Recommendations Interpret formulary and clinical program performance data — using available dashboards and reporting tools — to identify trends and opportunities. Translate data findings into clear, actionable clinical recommendations for clinical strategy leadership Support RFI and RFP submissions with data-driven clinical insights. AI-Enabled Workflows Actively incorporate AI tools into your daily workflow — from literature review and PA criteria drafting to formulary documentation and data summarization. Identify opportunities where AI can streamline clinical operations tasks and help the team scale effectively. Contribute to Rightway's evolving approach to AI adoption in clinical work; share learnings and best practices with the broader team. Leverage AI-assisted tools to synthesize clinical literature, draft policy language, and accelerate research tasks. Formulary Development/Strategy Support the development, maintenance, and updating of Rightway formularies, including standard and custom drug lists. Assist in formulary coding and collaborate with the claims platform team to ensure accuracy and functionality. Participate in formulary testing, validation, and ongoing quality review. Contribute to Pharmacy & Therapeutics (P&T) Committee meetings with drug evaluations, literature summaries, and formulary performance updates. Help explore and support the implementation of non-traditional formulary designs beyond tier-based structures. Prior Authorization & Clinical Policy Develop, maintain, and update prior authorization criteria and clinical coverage policies. Review PA criteria against current clinical evidence, payer benchmarks, and regulatory standards. Support clinical reviews and provide recommendations on complex or escalated PA cases, as needed. Assist in communicating PA criteria changes to operational teams, clients, and members. Partner with Director of Utilization Management on the implementation and operations of clinical strategy Cross-Functional Collaboration & Client Support Partner with Product, Data & Insights, Cost of Goods, and Client Operations teams to support formulary and clinical program implementation. Provide clinical support to operational teams and clients during implementation and ongoing account management. Facilitate communication and education to clients, members, and internal staff on clinical topics and formulary changes. WHO YOU ARE: PharmD required; active pharmacist licensure in at least one US state. 1–3 years of experience in managed care pharmacy, health plan, or PBM — OR successful completion of a managed care or health-system PGY1/PGY2 residency. Proficient with AI tools in a professional context — you regularly use tools like ChatGPT, Claude, Copilot, or similar to accelerate and improve your work. Working knowledge of formulary management, PA criteria development, and managed care fundamentals. Comfortable reading and interpreting data (e.g., dashboards, utilization reports) and translating findings into clinical recommendations. Strong written and verbal communication skills; able to distill complex clinical topics for non-clinical audiences. Organized, detail-oriented, and capable of managing multiple projects simultaneously. EXTRA CREDIT: Experience with PBM platform formulary coding or claims adjudication workflows. Familiarity with CMS formulary compliance requirements or Medicare Part D operations. Experience using AI tools for clinical literature review, policy drafting, or documentation workflows. Comfort working in a fast-paced, startup environment where processes are still being built. COMPENSATION:  $120,000 - $130,000 annually, in addition to bonus and equity Compensation offered will be determined by geographic location, experience, and qualifications. CYBERSECURITY AWARENESS NOTICE In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @ rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment.  ABOUT RIGHTWAY: 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. Rightway is a front door to healthcare, giving patients the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them. Since its founding in 2017, Rightway has raised over $200mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global. We’re headquartered in New York City, with satellite offices in Denver and Dallas. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs. HOW WE LIVE OUR VALUES TO OUR TEAMMATES: We’re seeking those with pass

More Remote jobs

Remote jobs · Browse all locations