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Careers at RxSense

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Operations Analyst

Job Title
Operations Analyst
Job ID
27559194
Location
Remote, 
Other Location
Description

Operations Analyst

Overview:

RxSense is a Boston-based health technology company offering powerful technology solutions built to make prescription drugs more affordable for all.  We operate two business units – Enterprise Platform Solutions, which provides turnkey technology services to employers, health plans, and others who wish to administer pharmacy benefits, and Direct to Consumer (DTC), which offers cash pay prescription benefits to people under the consumer brand SingleCare. 

Incorporated in 2014, RxSense is one of the fastest-growing companies in New England. We are privately held and proud to have been recognized by Fast Company as one of 2020’s Most Innovative Companies, and by Forbes as a 2020 Best Startup Employer.  Our CEO and Founder, Rick Bates, was named the EY New England Entrepreneur of the Year award winner in 2018. 

Job summary:

The Operations Analyst is responsible for reviewing adjudication data feeds as well as guiding decisions within Operations.  Key responsibilities include the review for newly implementing clients as well as performing gap analyses for prospective clients. Strong working knowledge of pharmacy claims processing or financial practices would be beneficial.

Primary Duties & Responsibilities:

To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Creates and populates audit/analysis spreadsheets and/or databases
  • Produces analysis of pharmacy networks based on service area, measuring potential member disruption, and overall network strategy
  • Produces reports for payment variances and/or rejected/denied/reduced claims
  • Collaborates with key stakeholders to support pharmacy growth initiatives
  • Oversite of claim monitoring processes, improving the intraday monitoring of adjudication
  • Various ad hoc requests, as requested
  • Establish and maintain relationships with client services, benefits administrations, implementations, UAT/QA, IT, finance, clinical staff with focus on accurate implementing requests
  • Assist the Director and staff with process and development projects
  • Other duties as assigned

Desired Knowledge, Skills & Ability:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

·        Demonstrates persistence and overcomes obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals.

·        Exhibits good listening and comprehension. Expresses ideas and thoughts in written form. Expresses ideas and thoughts verbally. Keeps others adequately informed. Selects and uses appropriate communication methods.

·        Achieves established goals. Completes work in a timely manner. Meets productivity standards. Strives to increase productivity. Works quickly.

Education &/ or Skills:

·        Bachelor’s degree in Accounting or Finance; or equivalent relevant experience.

·        Healthcare analytics experience including SQL with a desire to increase technical skills

·        4+ years of increasing responsibility in a PBM environment.

·        2 years’ experience in Data Analysis

PHYSICAL DEMANDS & WORK ENVIRONMENT:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

·        Regularly required to sit and talk or hear. Frequently required to stand and walk. 

·        Ability to sit for long periods of time and walk short distances.

·        Travel required is less than 30%.

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