Position Summary:

We are seeking a Data Analyst who will be responsible for delivering on-demand, automated, and customizable reporting and insights for internal stakeholders, regulatory entities, and external clients. The ideal candidate will combine strong technical skills with pharmacy claims knowledge and a passion for transforming raw data into actionable intelligence.

Essential Duties and Responsibilities: 

• Interpret data, analyze results, and provide ongoing reports.
• Identify, analyze, and interpret trends or patterns in complex data sets
• Work with business counterparts to understand the business context and requirements and apply them as a basis for the utilization and analysis of data.
• Gain a deep understanding of the data model, critical data entities and data elements in the data warehouse, data marts, and related databases.
• Acquire data from primary or secondary data sources for the purpose of analysis and reporting to business stakeholders.
• Build client facing output format and support automation for repeatable reports
• Perform root cause analysis on data issues or anomalies, and communicate findings clearly
• Contribute to developing scalable, self-service BI dashboard (e.g., in Qlik, or other BI tools)
• Collaborate cross-functionally to improve data pipelines, processes, and data governance

Qualifications:  

• Bachelor’s in mathematics, Computer Science, Information Management or Statistics. Post graduate degree preferred.
• 2 + years of relevant experience in the PBM and/or Health Plan Experience.
• Expertise in data models and data modelling.
• Knowledge and experience in process modelling.
• Ability to understand the business context and underlying processes, and to correlate them to the data.
• Deep knowledge and experience with data retrieval and manipulation with SQL queries.
• Experience with reporting packages (e.g. Qlik, Tableau) and statistical methods to analyze data and generate useful business reports.
• Familiarity with data warehouse architecture (Snowflake, MongoDB)
• Experience in working with large datasets and normalized pharmacy schemas
• Familiarity with API’s
• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy.
• Excellent communication skills with proven ability in requirements gathering, report writing and presenting findings.

Salary Range: $80,000 - $100,000

Position Summary

The Senior Data Engineer is responsible for building and operating the data infrastructure that powers RxSense’s analytics, AI systems, and business intelligence capabilities. You will work across Snowflake and SQL Server to design pipelines that move claims data, pricing data, and clinical information from operational systems into governed, accessible, and AI-ready formats. This role is critical to our AI-native transformation—every agentic system, pricing model, and clinical intelligence capability depends on reliable, well-governed data. You will also play a key role in solving longstanding data access and governance challenges, building the foundations that enable both humans and AI agents to work with data safely and efficiently.

Key Responsibilities

Data Pipeline Design and Operations

• Design, build, and maintain production-grade ETL/ELT pipelines that move data between SQL Server (operational), Snowflake (analytical), and downstream consumers including AI systems, reporting tools, and business intelligence platforms.
• Optimize data ingestion and transformation patterns for healthcare-scale volumes—millions of claims, pricing transactions, and member records processed daily.
• Implement data quality checks, validation rules, and monitoring that catch issues before they propagate to analytics, AI models, or regulatory reports.
• Build and maintain data models in Snowflake that support self-service analytics, enabling product, clinical, actuarial, and operations teams to answer their own questions.
• Manage pipeline scheduling, orchestration, and SLA monitoring to ensure data freshness targets are met across all business-critical data products.

Data Governance and Access

• Implement role-based access controls (RBAC) and data governance frameworks that enable squad-level and group-level data access rather than ad hoc individual permissions.
• Build and maintain data catalogs and lineage documentation that make it clear what data exists, where it comes from, what transformations have been applied, and who has access.
• Design data access patterns specifically for AI agents, ensuring agents can retrieve the data they need with appropriate authorization, audit trails, and containment boundaries.
• Ensure all data infrastructure complies with HIPAA requirements, including data de-identification for non-production environments, PHI access logging, and encryption at rest and in transit.
• Collaborate with security and IT teams to implement secrets management best practices for database credentials, API keys, and service accounts used in data pipelines.

Platform and Infrastructure

• Architect Snowflake environments for cost-effective performance, including warehouse sizing, clustering, materialized views, and query optimization strategies.
• Support the lower-environment data strategy by implementing alternatives to full production data replication, including data subsetting, synthetic data generation, and lookback-window-based approaches.
• Collaborate with DevOps and infrastructure teams on AWS-based data infrastructure, including S3 storage optimization, IAM policies for data access, and cost management across data storage tiers.
• Evaluate and implement data integration tools and frameworks that reduce pipeline development time while maintaining reliability and observability.

AI and Analytics Enablement

• Partner with the AI team to build data foundations for AI workloads, including feature stores, training data pipelines, and governed access to claims and pricing data for model development.
• Build data pipelines that support real-time and near-real-time use cases for AI-driven pricing, claims analysis, and clinical intelligence.
• Develop data products that leverage RxSense’s longitudinal claims data as a compounding competitive advantage—enabling trend analysis, formulary optimization, and cost management insights.
• Support the development of financial visibility tools that enable reporting on per-customer cost and spend, closing a critical gap in current business intelligence capabilities.

Requirements

• 5+ years of professional data engineering experience with strong proficiency in SQL and data pipeline development for production systems.
• Deep hands-on experience with Snowflake, including data modeling, performance optimization, warehouse management, and cost governance.
• Strong experience with SQL Server, including complex query development, stored procedures, and understanding of transactional database patterns.
• Proficiency in Python for data pipeline development, automation, and integration with cloud services and APIs.
• Experience with ETL/ELT tools and frameworks (dbt, Matillion, Airflow, or equivalent) and data orchestration patterns.
• Experience with AWS cloud services relevant to data engineering (S3, Glue, Lambda, IAM, or equivalent).
• Strong understanding of data governance, data quality frameworks, and access control models—particularly in environments with sensitive or regulated data.
• Experience building data catalogs, lineage documentation, or metadata management systems.
• Excellent problem-solving skills and a track record of building data systems that are reliable, well-documented, and maintainable by teams beyond the original author.
• Bachelor’s degree in Computer Science, Data Science, Engineering, or a related field, or equivalent practical experience.

Preferred

• Experience in healthcare, pharmacy benefits, health insurance, or a related regulated industry. Understanding of claims data structures, pharmacy transactions, or PBM operations is highly valued.
• Experience with healthcare data standards (HL7, FHIR, NCPDP) and HIPAA compliance requirements for data infrastructure.
• Experience building data infrastructure that supports AI/ML workloads, including feature engineering, training data management, and model serving pipelines.
• Familiarity with data de-identification techniques and strategies for managing PHI in non-production environments.
• Experience with Redis or distributed caching systems and understanding of how cached data layers interact with analytical systems.
• Track record of migrating or modernizing legacy data architectures into cloud-native platforms.
• Experience with data observability tools (Monte Carlo, Metaplane, or equivalent) and SLA-driven pipeline monitoring.

Salary Range: 140,000 - 150,000

Position Summary:

The Product Manager – Clinical & Authorization Platforms owns the strategy, roadmap, and execution of RxSense’s clinical rules infrastructure and prior authorization capabilities. This role is responsible for the platform functionality that enables clients to configure, operationalize, and scale their clinical policies and utilization management programs.

RxSense serves enterprise PBMs and healthcare organizations that define their own clinical criteria. The Product Manager ensures those client-defined rules—such as prior authorization requirements, step therapy protocols, quantity limits, refill-too-soon controls, and specialty restrictions—are accurately translated into configurable system logic and efficient workflows within the RxSense platform.

This role balances flexibility and standardization, ensuring the platform supports complex client configurations while maintaining performance, scalability, automation, and a high-quality provider and member experience.

To Be Successful in This Role, the Ideal Candidate Will

• Develop deep expertise in prior authorization, utilization management, and clinical edit frameworks.
• Understand how PBM-defined clinical criteria must be operationalized within configurable systems.
• Think holistically across adjudication engines, accumulators, benefit design, network configurations, and hierarchy-based (OCAG) inheritance models.
• Translate client requirements into scalable product capabilities rather than one-off custom solutions.
• Balance automation and human review workflows to optimize efficiency without compromising clinical controls.
• Use performance data to continuously refine rule precision, reduce false positives, and minimize provider/member friction.
• Demonstrate strong systems thinking, recognizing how clinical rules interact across the broader RxSense platform architecture.

Expectations

Clinical Rules Infrastructure Ownership

• Own the end-to-end clinical rules framework within the platform.
• Ensure accurate implementation of client-defined clinical criteria into configurable system logic.
• Design scalable configuration models that support multiple enterprise clients without degrading performance.
• Maintain consistency between formulary integration, clinical edits, and authorization workflows.

Authorization Workflow Strategy

• Lead the evolution of electronic PA submission, review, approval/denial, exception, and appeals processes.
• Improve authorization turnaround times and automation rates.
• Ensure determination messaging is clear, actionable, and configurable to meet client needs.

Platform Governance & Quality

• Maintain traceability between client requirements, system configuration, and adjudication outcomes.
• Partner with internal clinical SMEs and client stakeholders to implement updates tied to drug launches, safety changes, and rule adjustments.
• Define and monitor KPIs that measure workflow efficiency, automation, and rule effectiveness.

Product Leadership & Execution

• Own and prioritize the clinical platform backlog based on enterprise scalability, client impact, and operational value.
• Develop detailed feature specifications with measurable outcomes and acceptance criteria.
• Collaborate closely with engineering, architecture, clinical SMEs, operations, and commercial teams.
• Support client implementations and platform rollouts tied to clinical functionality.

Desired Skills & Experience

• 4+ years of experience in a PBM, health plan, or healthcare technology environment with direct exposure to prior authorization and utilization management workflows.
• 4+ years working within agile product teams, healthcare operations, or related environments.
• Experience working with clinical rules engines, decision support systems, or authorization platforms.
• Strong understanding of how clinical criteria are operationalized within adjudication and workflow systems.
• Familiarity with ePA standards and healthcare interoperability (e.g., NCPDP SCRIPT, FHIR).
• Experience operating within agile product environments and managing roadmaps/backlogs in JIRA (or similar tools).
• Proven ability to communicate effectively across engineering, clinical, operational, and executive stakeholders.
• Strategic mindset with the ability to connect platform capabilities to client needs and business growth objectives.

Salary Range: 100,000 - 149,000

Position Summary:

The Product Manager owns the strategy, roadmap, and delivery of core healthcare benefit solutions, including Coordination of Benefits (COB), Pharma Copay programs, Client Organization Model Administration (Hierarchy), the Member Portal experience, and high-level Benefit Administration Portal navigation. This role is responsible for defining and executing a product vision that delivers measurable value to payers, PBMs, pharmacies, manufacturers, and ultimately patients—balancing regulatory requirements, operational efficiency, platform usability, and user experience.

In addition to core benefit functionality, this role oversees the administration of complex client hierarchies that mirror real-world organizational structures, ensuring scalable and flexible configuration across enterprise customers. The Product Manager also drives the evolution of the Member Portal, delivering intuitive, self-service capabilities that improve engagement, transparency, and satisfaction. At the platform level, they shape the enterprise navigation framework within RxIQ to ensure consistent, logical, and efficient user flows across modules supporting role-based workflows without extending into identity and access management ownership.

By deeply understanding customer workflows, industry standards, and compliance considerations, the Product Manager identifies opportunities to streamline benefit processing, improve financial accuracy, reduce friction across stakeholders, and enhance program performance. They translate business and market needs into clearly defined product requirements, prioritized backlogs, and outcome-based success metrics. Through close partnership with engineering, architecture, operations, and commercial teams, they ensure scalable, reliable, and compliant solutions are delivered with clarity around scope, acceptance criteria, and quality expectations.

The role also drives continuous improvement through data-driven experimentation and iteration—leveraging launch results, performance metrics, and customer feedback to optimize capabilities, expand impact, and inform strategic investment decisions. As the product manager for these critical benefit platforms and enterprise experience layers, this leader ensures alignment across cross-functional teams while maintaining a strong focus on long-term platform scalability, customer value, and business growth.

To Be Successful in This Role, the Ideal Candidate Will

• Develop deep expertise across Coordination of Benefits (COB), Pharma Copay programs, Client Organization Model Administration (Hierarchy), Member Portal experiences, and Benefit Administration Portal navigation.
• Understand how enterprise client hierarchies mirror real-world organizational structures and how those structures drive benefit configuration, eligibility, reporting, and operational workflows.
• Distill complex healthcare benefit, compliance, and platform concepts into clear, actionable insights for both technical and non-technical stakeholders.
• Balance regulatory requirements, operational efficiency, financial accuracy, and user experience when defining product direction.
• Think holistically about the enterprise platform experience—ensuring cohesive navigation and intuitive workflows across modules.

Expectations

• Serve as the subject matter expert for COB, Pharma Copay programs, Client Organization Model Administration (Hierarchy), Member Portal capabilities, and Benefit Administration Portal navigation within RxIQ.
• Lead strategy and execution for system enhancements, new client implementations, RFP support, and configuration models across these domains.
• Ensure client organizational structures are scalable, flexible, and accurately represented within the platform to support complex enterprise needs.
• Drive evolution of the Member Portal to enhance self-service capabilities, transparency, and engagement for end users.
• Shape and optimize high-level enterprise navigation patterns to ensure consistent, logical, and efficient user flows across the RxIQ platform (excluding direct IAM ownership).
• Remain current with regulatory and industry requirements (COB, Medicare, Medicaid, and related benefit regulations) to ensure ongoing compliance.
• Partner with engineering, architecture, operations, and commercial teams to define quarterly roadmaps aligned to long-term platform vision.
• Collaborate across adjudication and other core enterprise product areas to maintain a comprehensive understanding of the full RxSense platform ecosystem.
• Own and manage the product backlog, prioritizing development based on measurable business impact, customer value, scalability, and risk mitigation.
• Develop detailed feature specifications with clear acceptance criteria and outcome-based success metrics.
• Leverage data, performance metrics, launch outcomes, and customer feedback to drive continuous improvement and strategic investment decisions.
• Demonstrate strong systems thinking and intellectual curiosity to understand how benefit logic, hierarchy models, and enterprise workflows function at a foundational level.
• Define and execute a forward-looking strategy across benefit platforms and enterprise experience layers that aligns with RxSense business goals and customer needs.
  
  
  

Desired Skills & Experience

• 4+ years of experience at a PBM or healthcare organization, with direct exposure to Coordination of Benefits (COB), Medicaid, and/or Medicare programs.
• 4+ years working within agile product teams, business functions, or related environments.
• Experience with benefit administration platforms, organizational hierarchy models, or enterprise SaaS configuration tools strongly preferred.
• Familiarity with member-facing web or mobile portal experiences and UX considerations.
• Understanding of enterprise SaaS navigation frameworks and cross-module user experience design.
• Experience using JIRA (or similar tools) for roadmap planning, backlog management, sprint visualization, and prioritization.
• Proven ability to self-manage, make data-driven decisions, and operate both autonomously and collaboratively in cross-functional environments.
• Strong written and verbal communication skills, with demonstrated ability to align engineering, operations, compliance, and commercial stakeholders.
• Strategic mindset with the ability to connect platform scalability, customer value, compliance requirements, and business growth objectives.

Salary Range: 100,000 - 149,000

Position Summary:

Senior Software Engineer (Full Stack) will be expected to deliver stellar results as part of a small, cross- functional, largely autonomous product engineering team, collaborating with other developers, designers, and the product manager to extend our cloud-based web platform. This role will contribute to features and projects, from brainstorming, development, through to testing, release, and maintenance.

Essential Duties and Responsibilities:

• Build products for internal and external users across the stack and a firm understanding of web frameworks, APIs, databases, and multiple back-end languages.
• Partner with engineering managers, lead engineers, product managers and designers to deeply understand the needs of our users to architect and leverage most effective technical solution to build a product that serves those needs.
• Design and develop software capable of reaching millions of
• Write modular, secure, and well-tested
• Ensure our development environment is best in class by delivering improvements to internal tooling and direct partnership with our product platform teams.
• Articulate a technical vision for a more enlightened way of working and work with multi-functional partners to deliver that vision.
• Ensure code quality and participate in code
• Promote collaboration and best practices such as simplicity, automation, good design patterns, code coverage and reusability.
• Own and maintain existing application platforms as part of the team, and look for opportunities to improve them.

Education/Experience/Competencies:

• BS (or higher, e.g., MS, or Ph.D.) in Computer Science or related technical field involving coding, or equivalent technical experience.
• 5+ years of work-related industry experience developing high-performance web applications in C#/ .NET.
• Experience writing RESTful microservices with a popular web
• Extensive knowledge of your development stack; for example, with C#, have a comprehensive understanding of the .NET, .NET Core, MVC, WebAPI, IIS etc.
• 3+ years of experience as a Full Stack Engineer and knowledge of Front-End languages such as JavaScript, React, Angular.
• Good working knowledge of HTML, CSS, and Javascript
• Strong CS fundamentals with experience across a range of disciplines, with one or more areas of deep knowledge and experience
• Consistent track record of developing, shipping, and maintaining large-scale web applications with a user
• Experience working with AWS offerings such as EC2, ALBs, RDS, Beanstalk, API Gateway or with a different cloud provider and similar services.
• Demonstrated experience to understand the tradeoffs to technical design decisions, risk assessment and mitigation activities.
• Experience in analyzing and troubleshooting application issues in timely fashion.
• Proven analytical thinking and problem-solving
• Must have excellent communication skills both verbal and
• Enthusiasm for technology, and an aptitude for learning and using new

Bonus Qualifications:

• Experience in Agile development methodologies, preferably both Scrum and
• Experience with unit testing using frameworks like
• Enthusiasm to work anywhere in the stack, especially in unfamiliar
• Enthusiasm for modern DevOps practices (including containerization and Kubernetes deployments).
• Good working knowledge of API
• Experience with specific technologies such as Redis, ElasticSearch

Salary Range: $140,000 - $155,000

• Boston, MA
• Princeton, NJ