Job Description
ABOUT THE ROLE:
We’re hiring an Analytics Engineer to help design and build a PBM Financial Risk Engine that brings together claims, contract terms, pricing and utilization data to support financial forecasting, risk assessment and performance monitoring. This role is ideal for someone who is strong in dbt and analytics engineering and who enjoys working at the intersection of healthcare economics, PBM operations and data modeling. The ideal candidate will play a pivotal role in developing and maintaining our financial risk engine data models, onboarding new data sources and optimizing existing data sources and packaging the data in a way that promotes seamless reporting while paving a way for innovation through advanced analytics. This role will involve delivering and analyzing PBM financial data for various analytics use cases within our Unified Data Warehouse (UDW) and productionalizing AI and ML solutions through the curated data to drive impactful healthcare insights.
WHAT YOU’LL DO:
- Apply hands on analytics and data expertise to solve complex, fast moving financial and operational problems using PBM data.
- Design, develop and maintain scalable, analytics ready data models (primarily in dbt) that power a PBM financial risk engine, leveraging claims, eligibility, pricing, rebates, guarantees and contract data in our Unified Data Warehouse (UDW).
- Translate complex PBM contract and pricing structures (e.g plan paid vs. member paid, rebates, guarantees, caps, fees, exclusions) into transparent, auditable data models that enable financial analysis and risk assessment.
- Partner closely with underwriting, finance, client success and PBM operations teams to understand financial assumptions, risk drivers and reporting requirements and convert them into reliable metrics and models.
- Build curated financial and risk data marts and semantic layers that enable self service analysis for forecasting, scenario modeling and executive reporting among other things.
- Own core financial KPIs and risk metrics E2E from raw claims and contract inputs through production grade models, ensuring consistency and traceability.
- Implement automated data quality checks, reconciliations and controls to validate financial outputs and ensure alignment with source systems and contractual logic.
- Continuously optimize data models and warehouse performance to support large scale claims volumes and time-sensitive financial analysis.
- Contribute to data governance by establishing modeling standards, documentation and guardrails that support auditability, explainability and long term maintainability.
- Communicate complex financial insights clearly through data memos, documentation and presentations for both technical and non technical stakeholders.
- Explore advanced analytics and predictive modeling use cases (e.g utilization forecasting, trend analysis, risk stratification, margin sensitivity) to enhance financial planning and decision making. Experience operationalizing ML models is a plus.
WHO YOU ARE:
- Expert level proficiency in SQL and statistical programming (Python, R).
- 3 to 4 years working experience with data modeling, dbt and analytics engineering best practices (testing, documentation, incremental models, semantic layers).
- Experience in cloud platforms (preferably in AWS) and hands-on experience in cloud data warehouses (Redshift or Snowflake).
- Business acumen with exposure to PBM, healthcare finance, underwriting or actuarial concepts.
- Experience modeling large scale claims data and translating contractual or financial rules into clear, testable data logic.
- Strong analytical and problem-solving skills.
- Ability to understand, tackle, and solve problems from both technical and business perspectives.
- Comfortable partnering closely with finance, underwriting and operations stakeholders to align data models with real world financial decisions.
- High attention to detail and a bias toward accuracy, transparency and explainability in financial reporting.
SALARY (Before Bonus Potential): $140,000
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 $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. 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 that embody our following core values:
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.
