Job description

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 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.

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