Pricing Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of MAC management for the Enterprise book: create, sustain, and refresh MAC lists, which include client-specific and dedicated lists, ensuring that pricing is precise, competitive, and in alignment with client and pharmacy contracts.

• Oversee MAC factor and multiplier modifications across clients, conducting quality assurance on every pricing export and upload prior to it going live.

• Track client and pharmacy pricing performance versus contractual commitments, identify gaps early, and formulate pricing strategies to address them before year-end reconciliation.

• Construct and manage pricing for new and renewing clients, collaborating with Client Experience and implementation teams to ensure pricing is correctly established and timely for each go-live.

• Address MAC pricing escalations, appeals, and intricate pricing tickets, serving as the escalation point for pricing inquiries throughout the organization.

• Examine client and pharmacy contract terms for pricing implications, maintaining accurate contract and pricing details to facilitate performance tracking.

• Assist in the quarterly and annual reconciliation of client and pharmacy contracts, producing reports and analyses for leadership regarding contract compliance and pricing performance.

• Prioritize the incoming flow of pricing requests, establish clear turnaround expectations with the business, and keep the team focused on high-value tasks.

• Collaborate with Network Operations, Clinical, and Underwriting on pricing decisions impacting pharmacy networks, formulary, and new-business proposals.

• Work alongside the AI and data teams to outline requirements for and implement automated pricing tools, including algorithmic MAC management for a wider range of clients.

• Lead, mentor, and develop the pricing team, creating documented, repeatable processes to eliminate single points of failure in MAC management.

• Conduct ad hoc analyses on client and pharmacy performance, examining volume trends, drug seasonality, and financial outcomes.

• Success is defined by reliable documented MAC management, tracked client and pharmacy guarantees, a clear pricing strategy with defined turnaround expectations, and regular utilization of automated pricing tools.

⛳️ Requirements

• Proven hands-on experience in managing MAC in a PBM or pharmacy environment: developing and maintaining MAC lists, handling MAC factor adjustments, and performing quality checks on pricing prior to launch.

• Bachelor’s degree in finance, Business, Economics, or a related discipline.

• A minimum of 5 years of experience in PBM or retail pharmacy pricing, including direct MAC management, with at least two years in a supervisory or leadership role; or an equivalent combination of education and experience.

• Comprehensive understanding of PBM pricing economics, including client and pharmacy contract terms, pricing guarantees, and reconciliation processes.

• Experience in monitoring pricing performance against guarantees and translating variances into corrective pricing actions.

• Background in setting up pricing for client implementations and renewals under tight deadlines.

• Capability to articulate pricing clearly to non-technical stakeholders and act as a reliable, credible resource for the business regarding pricing decisions.

• Experience in leading, coaching, or mentoring analysts while developing documented, repeatable processes.

• Advanced skills in Excel.

• Experience with SQL, Tableau, or other BI tools is preferred.

• Previous experience in adopting automated or AI-enabled pricing tools as a business owner, rather than as a developer, is preferred.

• Experience in a rapidly growing healthcare technology organization is preferred.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health and wellness benefits.

• Professional development opportunities and support for continuing education.

• Flexible working arrangements to promote work-life balance.