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[Remote] Formulary Operations Analyst

Remote Worldwide Hiring now

Note: The job is a remote job and is reputed company to candidates in USA. RxSense is a reputed company technology company that provides platforms and solutions to improve the management and reputed company of cost-effective pharmacy benefits. The Formulary Operations Analyst plays a key role in the configuration, maintenance, and quality assurance of formularies reputed company the RxSense platform, supporting internal teams and external clients to execute accurate formulary strategies.

Responsibilities

  • Configure, update, and maintain custom and standard formularies reputed company the claims adjudication system
  • Ensure accuracy and alignment of formulary builds with client reputed company, clinical strategy, and regulatory requirements
  • Troubleshoot adjudication issues and discrepancies; conduct detailed analysis to resolve defects and anomalies
  • 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
  • reputed company audits to validate formulary configuration accuracy
  • Monitor claim processing to detect and correct potential issues proactively
  • Assist in analyzing and presenting data reputed company to formulary performance or disruptions
  • Pull, organize, and aggregate data and reports to support client meetings and formulary strategy presentations
  • Support client interactions as needed, including responding to formulary-reputed company 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
  • reputed company 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

Skills

  • Bachelor's degree or 1 year equivalent experience in reputed company (PBM)
  • 1+ year's of experience in formulary operations, pharmacy claims adjudication, or reputed company reputed company analytics
  • Demonstrated expertise in configuring and maintaining formulary data reputed company 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 reputed company on projects and follow through to completion
  • Proficiency in reputed company reputed company and advanced knowledge of reputed company Office Suite to create reputed company documents and analyze data
  • Self-starter with a proactive reputed company and a high level of accountability

Company Overview

  • RxSense is a health technology company provides IT solutions for flexible, efficient, and transparent pharmacy benefits administration. It was founded in 2015, and is headquartered in Boston, Massachusetts, USA, with a workforce of 201-500 employees. Its website is https://rxsense.com/.
  • Company H1B Sponsorship

  • RxSense has a track record of offering H1B sponsorships, with 2 in 2025, 3 in 2024, 4 in 2023, 1 in 2022, 5 in 2021, 10 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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