We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.
As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem. With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.
Position summary
The Manager of Pricing leads pricing administration for RxSense's Enterprise clients and pharmacy partners, with MAC management as the core of the role. This person owns the creation and maintenance of MAC lists and MAC pricing adjustments, monitors pricing performance against client and pharmacy guarantees, and ensures pricing is applied accurately across clients. The Manager of Pricing is the team's go-to resource for pricing strategy and complex problem-solving, and a trusted advisor to the business on pricing decisions. The role partners closely with Client Experience, Network Operations, Clinical, Underwriting, and our AI and data teams, who support the reporting and technical tooling behind our pricing processes. The Manager of Pricing also leads and develops the pricing team and performs ad hoc analysis on client and pharmacy performance.
Responsibilities
Own MAC management for the Enterprise book: create, maintain, and update MAC lists, including client-specific and dedicated lists, so pricing is accurate, competitive, and aligned with client and pharmacy contracts.
Manage MAC factor and multiplier adjustments across clients, with quality assurance on every pricing export and upload before it goes live.
Monitor client and pharmacy pricing performance against contractual guarantees, surface gaps early, and develop pricing strategies to close them before year-end reconciliation.
Build and administer pricing for new and renewing clients, partnering with Client Experience and implementation teams so pricing is set up correctly and on time for each go-live.
Resolve MAC pricing escalations, appeals, and complex pricing tickets, and serve as the escalation point for pricing questions across the business.
Review client and pharmacy contract terms for pricing implications, and maintain accurate contract and pricing information as the basis for performance tracking.
Support quarterly and annual reconciliation of client and pharmacy contracts, and produce reporting and analysis for leadership on contract compliance and pricing performance.
Prioritize the inbound flow of pricing requests, set clear turnaround expectations with the business, and keep the team focused on the highest-value work.
Partner with Network Operations, Clinical, and Underwriting on pricing decisions that affect pharmacy networks, formulary, and new-business proposals.
Partner with the AI and data teams, who own the technical tooling, to define requirements for and adopt automated pricing tools, including algorithmic MAC management for a broader set of clients.
Lead, coach, and develop the pricing team, building documented, repeatable processes so MAC management has no single point of failure.
Perform ad hoc analysis on client and pharmacy performance, including volume trends, drug seasonality, and financial results.
What success looks like
MAC management runs reliably, with documented processes and no single point of failure.
Client and pharmacy guarantees are tracked and on plan, including through new client implementations.
The pricing team has a clear go-to for strategy and problem-solving, and the business has clear turnaround expectations.
Automated pricing tools from the AI and data teams are part of the team's regular workflow.
Qualifications
Hands-on experience owning MAC management in a PBM or pharmacy setting:…