Data Analyst III, PBM Business and Operations

ABOUT THE ROLE: 

We are seeking a full-time Business and Operations Analyst III to join our Data & Insights team. In this role, you’ll be responsible for creating data analyses that demonstrate our company’s impact to clients and strategic partners in the PBM space. You will support the development and execution of analytics, provide data-driven strategic insights, and create customized analytic approaches in a pharmacy benefits setting. This role supports Rightway’s clinical delivery, operations, and other internal departments by developing and delivering complex analytical needs, including quarterly performance reviews and ad hoc client inquiries. Additionally, as a Business and Operations Data Analyst III, you will support strategic decision-making processes to optimize our PBM services.

WHAT YOU’LL DO: 

• Work cross-functionally with PBM operational teams including Eligibility and Claim Operations, Configuration, and Contact Center to deliver actionable insights and strategic recommendations that support operational goals.
• Refine and enhance data infrastructure and processes to improve the scalability and efficiency of PBM services.
• Leverage knowledge of PBM practices, adjudication logic, regulatory requirements, and industry trends to guide analytics and decision-making.
• Build tools and reporting capabilities to monitor claims and enrollment data for trends, anomalies, or processing variances, enabling operational teams to act on performance improvement opportunities.
• Design and maintain dashboards and monitoring solutions to track claims processing metrics, operational KPIs, and performance guarantee compliance.
• Create and manage standardized reporting for internal stakeholders and external clients to support daily operations, audits, and client reporting needs.
• Apply advanced statistical techniques to assess PBM program performance and build repeatable measures for operational effectiveness.
• Develop analytic frameworks and methodologies to support strategic initiatives and enable data-driven operational improvements.
• Translate complex data findings into clear, actionable insights using reports, dashboards, and presentations tailored to a range of stakeholders.
• Partner with internal teams to identify and evaluate opportunities for AI and automation in PBM operations and support implementation planning.

WHO YOU ARE: 

• Bachelor’s degree in Analytics, Computer Science, or related field, or equivalent work experience.
• Proficiency with SQL, relational databases and database structures
• Experience in the pharmacy industry and understanding of PBM operations.
• Experience with data visualization tools (e.g., Tableau, Power BI, Metabase) 
• 4-8 years of experience in quantitative analytics and conducting advanced analytic modeling for large pharmacy and clinical datasets.
• 5+ years of industry experience querying and analyzing pharmacy claims and clinical program data.
• Basic understanding of AI, Generative-AI, and Machine Learning frameworks.
• Experience gathering and documenting requirements from clients or the business.
• Ability to communicate analysis to business partners and clients both in writing and verbally.
• Excellent communication and interpersonal skills.
• Experienced with developing data tools, memos, and presentations to deliver data and insights to stakeholders.
• Proven ability to guide standards and provide leadership and mentorship to junior team members.

EXTRA CREDIT: 

• Proficiency in statistical software (Python, R).
• Proficiency with dbt.
• Experience with version control.
• Hands on AWS experience is a plus.

BASE SALARY: $100,000 - $135,000

Offer amounts for both remote and in office roles are influenced by geographic location.

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. If you have any questions about a suspicious interaction with Rightway, please feel free to reach out to us at hr@rightwayhealthcare.com.

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 a satellite office in Denver. 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 who will:

• 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. 

• 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.

• 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.

• 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.

• 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 PROUDLY an Equal Opportunity Employer that believes in strength in the diversity of thought processes, beliefs, background and education and fosters an inclusive culture where differences are celebrated to drive the best business decisions possible. We do not discriminate on any basis covered by appropriate law. All employment is decided on the consideration of merit, qualifications, need and performance.