Clinical, Formulary Management Pharmacist

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 passion for healthcare and relentless devotion to our goal. We need team members that embody our core values:

1. We are human, first Our humanity binds us together. We bring the same empathetic approach to every individual we engage with, whether it be our members, our clients, or each other. We are all worthy of respect and understanding and we engage in our interactions with care and intention. We honor our stories. We listen to—and hear—each other, we celebrate our differences and similarities, we are present for each other, and we strive for mutual understanding.

2. We redefine what is possible We always look beyond the obstacles in front of us to imagine new solutions. We approach our work with inspiration from other industries, other leaders, and other challenges. We use ingenuity and resourcefulness when faced with tough problems.

3. We debate then commit We believe that a spirit of open discourse is part of a healthy culture. We understand and appreciate different perspectives and we challenge our assumptions. When working toward a decision or a new solution, we actively listen to one another, approach it with a “yes, and” mentality, and assume positive intent. Once a decision is made, we align and champion it as one team.

4. We cultivate grit Changing healthcare doesn’t happen overnight. We reflect and learn from challenges and approach the future with a determination to strive for better. In the face of daunting situations, we value persistence. We embrace failure as a stepping stone to future success. On this journey, we seek to act with guts, resilience, initiative, and tenacity.

5. We seek to delight Healthcare is complicated and personal. We work tirelessly to meet the goals of our clients while also delivering the best experience to our members. We recognize that no matter the role or team, we each play a crucial part in our members’ care and take that responsibility seriously. When faced with an obstacle, we are kind, respectful, and solution-oriented in our approach. We hold ourselves accountable to our clients and our members’ success.

Rightway is proud to be an Equal Opportunity Employer that believes in the strength of diverse thought, beliefs, backgrounds, and education. We foster an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis protected by applicable law. All employment decisions are based on merit, qualifications, need, and performance.