Data File Management 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 Data File Management Analyst is responsible for ensuring that our clients’ inbound data is received and loaded successfully on a daily basis, analyzing the results of the automated loader processes, troubleshooting errors in client data and/or system processes, and communication with internal and external customers. The Data File Management Analyst is also responsible for ensuring that outbound data files are generated and delivered to our clients on a routine basis.

Primary Duties & Responsibilities:

The person who fills this role will be a critical thinker, who not only can understand the underlying process for receiving, validating, processing and loading client data, but comprehend how that data is used by the system once loaded. Leveraging this understanding, the Data File Management Analyst will be more effective in troubleshooting issues, determine root causes and recommend solutions.

The preferred candidate for this role is someone with experience in the PBM and/or pharmacy industry, with a deep understanding of plan design and pharmacy claims processing. Key areas for managing client data will include Eligibility, Accumulators, Prior Authorizations, Claims.

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.

·        Documentation management (maintaining specifications, file layout documents, and SOPs), new client implementation management and testing of client data files.

·        Ability to use rudimentary software tools (text editors and spreadsheets) to open, view, and occasionally manipulate raw data.

·        Problem solving and critical thinking

·        Verbal and written communication

·        Knowledge and experience in PBM operations

·        Willingness to learn and aptitude to comprehend data analysis, eligibility, accumulators, prior authorizations and claims data

Education &/ or Experience:

Post High School and/ or bachelor’s degree in relevant field preferred but not required.

Preferred 3+ years experience in the PBM industry