Pharmacy Network Coordinator

ABOUT THE ROLE:

The Pharmacy Network Coordinator supports the day-to-day management of Rightway's retail, mail-order, and specialty pharmacy networks. This person keeps network data accurate, coordinates pharmacy onboarding and credentialing, and works cross-functionally with claims, client success, and clinical teams to make sure members always have reliable access to the pharmacies they need.

WHAT YOU’LL DO:

• Maintains and audits pharmacy network directories, contracts, and credentialing records for accuracy and compliance.  This includes obtaining applicable licenses and certificates of insurance from pharmacies, as well as verifying eligibility through the NCPDP database and federal and state sources (e.g., OIG, GSA, SAM).
• Coordinates onboarding, terminations, and status changes for retail, mail-order, and specialty pharmacies.
• Serves as a day-to-day point of contact for network pharmacies, resolving claims, enrollment, and access issues.
• Partners with the claims and clinical teams to troubleshoot pharmacy-level adjudication and payment issues. 
• Supports the benefit and navigation team with network-related issues. 
• Develops and delivers ad hoc network reports for clients.
• Helps documen