PBM Operations Associate

Rightway

PBM Operations Associate supporting eligibility, accumulator, and claims data feeds for Rightway’s healthcare navigation and pharmacy benefit management platform. Ensuring accurate, timely data delivery and troubleshooting integrations.

Posted 8/12/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $65,000 - $85,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing eligibility, accumulator, and claims data feeds while ensuring accuracy and timely delivery to stakeholders. Possesses strong analytical skills and the ability to collaborate effectively with various internal and external teams.

Highest-signal resume keywords

Eligibility Data ManagementClaims File FeedsData TroubleshootingHealthcare OperationsExcel Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisEligibility OperationsAccumulator ManagementClaims ProcessingFile Feed Management

Soft Skills

Detail-OrientedOrganizational SkillsConsultative ApproachOwnershipAdaptability

Industry Keywords

Healthcare OperationsPBMHealth PlanData OperationsThird-Party Integrations

About the role

Key responsibilities & impact

Support execution of eligibility and accumulator file feeds and interfaces from implementation through ongoing operations and maintenance
Support claims extract file feeds, ensuring data is accurate, complete, and delivered to external stakeholders on schedule
Serve as a day-to-day resource for eligibility, accumulator, and claims extract data needs
Collaborate with engineering, client success, implementations, benefit administration, and other internal stakeholders
Monitor downstream vendor feeds and third-party integrations, escalating and troubleshooting issues
Research and troubleshoot day-to-day inquiries or issues related to eligibility, accumulators, and claims data feeds
Maintain accurate, up-to-date documentation of processes and internal controls
Take on additional responsibilities as business needs evolve and work additional hours during peak seasons when needed

Requirements

What you’ll need

Bachelor's degree preferred; relevant experience considered for exceptional candidates
2–4 years of experience in healthcare operations, PBM, health plan, or data/eligibility operations; entry-level candidates with strong analytical skills encouraged to apply
Detail-oriented and organized, with strong ownership and ability to work in a fast-paced environment with shifting priorities
Comfortable learning new systems and platforms
Consultative approach with internal and external stakeholders
Working knowledge of Excel
Ability to research and troubleshoot data discrepancies
Experience with eligibility, accumulator, or claims file feeds

Benefits

Comp & perks

Bonus
Equity
Remote work arrangement