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Operations Analyst I

Princeton, NJ, Palm Beach Gardens, FL, Boston, MA

We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem.  With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

Position Summary

The Operations Analyst I – File Management is responsible for ensuring the accurate and timely processing of inbound and outbound data files critical to RxSense's PBM operations. This role involves monitoring automated data loading processes, troubleshooting errors, and collaborating with internal and external stakeholders to resolve issues. The analyst will develop a comprehensive understanding of data flows related to eligibility, accumulators, prior authorizations, and claims to support operational excellence. This position may require occasional extended hours to meet critical deadlines.

 

Essential Duties & Responsibilities:

  • Monitor and validate the successful receipt and processing of inbound client data files on a daily basis.
  • Analyze results from automated loader processes and identify discrepancies or errors in client data or system processes.
  • Troubleshoot and resolve data-related issues, coordinating with internal teams and external clients as necessary.
  • Ensure the accurate generation and delivery of outbound data files to clients according to established schedules.
  • Maintain comprehensive documentation, including file specifications, layout documents, and standard operating procedures (SOPs).
  • Support new client implementations by managing data file testing and validation processes.
  • Collaborate with cross-functional teams to understand how loaded data is utilized within the system, enhancing troubleshooting effectiveness.
  • Contribute to continuous improvement initiatives aimed at enhancing data processing efficiency and accuracy.

 

Qualifications:

  • Bachelor's degree in a related field or equivalent work experience.
  • 1–2 years of experience in PBM operations, pharmacy, or healthcare data management preferred.
  • Familiarity with data file structures related to eligibility, accumulators, prior authorizations, and claims.
  • Proficiency in using text editors and spreadsheet software to view and manipulate raw data files.
  • Strong problem-solving skills and critical thinking abilities.
  • Excellent verbal and written communication skills.
  • Demonstrated ability to learn and comprehend complex data analysis processes.
  • Detail-oriented with a commitment to data accuracy and integrity.

Preferred Qualifications:

  • Experience with PBM systems and understanding of plan design and pharmacy claims processing.
  • Knowledge of industry standards and regulations related to pharmacy benefits management.

Salary Range: $58,000 - $88,000

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. 

In Office Policy:  Candidates within a commutable distance to one of the offices listed below will be expected to commit to a hybrid in office schedule if selected.

  • Boston, MA
  • Princeton, NJ
  • New York City, NY
  • West Palm Beach, Florida

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