Back to jobs
New

Formulary Operations Analyst

Princeton, New Jersey, United States, Remote

RxSense is a leading healthcare technology company delivering innovative solutions for pharmacy benefits and prescription savings. Our enterprise platform brings transparency, flexibility, and efficiency to pharmacy benefit management, helping clients streamline operations and enabling consumers to save on prescriptions. By integrating intelligence across the pharmacy ecosystem, RxSense makes cost-effective healthcare more accessible. Whether for PBMs, pharmacies, or individuals, our solutions help modernize operations, reduce costs, and improve outcomes. 

RxSense also owns and operates SingleCare, a free prescription savings service that offers consumers access to consistently low prices on prescription drugs. Through its partnerships with the country’s largest pharmacies and grocers, including CVS, Walgreens, Walmart, Kroger and Albertsons, SingleCare improves access and adherence to affordable medications and has helped millions of Americans save over $11 billion on their medications. 

RxSense is a great place to work! Our company has earned several prestigious awards, including Fast Company’s Most Innovative Companies, Forbes’ Top Startup Employers, Modern Healthcare's Best Places to Work in Healthcare, and Inc’s Best in Business and Best Workplaces.

Position Summary:      

The Formulary Analyst plays a key role in the configuration, maintenance, and quality assurance of formularies within the RxSense platform. Acting as a subject matter expert, the Analyst supports both internal teams and external clients in executing accurate formulary strategies and ensuring alignment with clinical and operational goals. This position requires strong technical proficiency, a deep understanding of pharmacy claims systems, and the ability to work independently on complex issues and projects.

Essential Duties and Responsibilities:

Formulary Configuration and Maintenance

  • Configure, update, and maintain custom and standard formularies within the claims adjudication system.
  • Ensure accuracy and alignment of formulary builds with client intent, clinical strategy, and regulatory requirements.
  • Troubleshoot adjudication issues and discrepancies; conduct detailed analysis to resolve defects and anomalies.

Support for Implementations and Enhancements

  • Participate in client implementations by gathering and documenting formulary requirements.
  • Serve as a clinical capabilities subject matter expert.
  • Collaborate with internal teams to ensure smooth integration of formulary solutions.

Quality Control and Reporting

  • Perform audits to validate formulary configuration accuracy.
  • Monitor claim processing to detect and correct potential issues proactively.
  • Assist in analyzing and presenting data related to formulary performance or disruptions.
  • Pull, organize, and aggregate data and reports to support client meetings and formulary strategy presentations.

Client and Team Collaboration

  • Support client interactions as needed, including responding to formulary-related inquiries and assisting in training sessions.
  • Work closely with clinical partners to ensure translation of clinical direction into accurate system configuration.
  • Contribute to development and documentation of internal workflows, best practices, and training materials.

Special Projects and Process Improvements

  • Lead or contribute to special initiatives such as process optimization, disruption analyses, or platform enhancements.
  • Recommend and implement improvements to ensure greater accuracy, efficiency, and scalability of formulary operations.

 

Education/Experience:

  • Bachelor’s degree or 1 year equivalent experience in healthcare (PBM)
  • 1+ year's of experience in formulary operations, pharmacy claims adjudication, or related healthcare analytics.
  • Demonstrated expertise in configuring and maintaining formulary data within claims systems.
  • Excellent working knowledge of formulary structures, Medispan/FDB data, and pharmacy benefit operations.
  • Strong problem-solving skills with the ability to analyze data and translate findings into actionable solutions.
  • Detail-oriented, with the ability to manage multiple priorities and meet deadlines.
  • Superior written and verbal communication skills — clear and concise with both internal and client-facing audiences.
  • Excellent organizational and time management skills.
  • Ability to take the lead on projects and follow through to completion.
  • Proficiency in Microsoft Excel and advanced knowledge of Microsoft Office Suite to create complex documents and analyze data.
  • Self-starter with a proactive mindset and a high level of accountability.     

Salary Range: 75,000 - 85,000

RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin.  Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status.  We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings. 

Apply for this job

*

indicates a required field

Resume/CV

Accepted file types: pdf, doc, docx, txt, rtf

Cover Letter

Accepted file types: pdf, doc, docx, txt, rtf

Select...
Select...

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in RxSense’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

Select...
Select...
Race & Ethnicity Definitions

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Select...

Voluntary Self-Identification of Disability

Form CC-305
Page 1 of 1
OMB Control Number 1250-0005
Expires 04/30/2026

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

  • Alcohol or other substance use disorder (not currently using drugs illegally)
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
  • Blind or low vision
  • Cancer (past or present)
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or serious difficulty hearing
  • Diabetes
  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
  • Epilepsy or other seizure disorder
  • Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
  • Intellectual or developmental disability
  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
  • Missing limbs or partially missing limbs
  • Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
  • Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
  • Partial or complete paralysis (any cause)
  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
  • Short stature (dwarfism)
  • Traumatic brain injury
Select...

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.