Pharmacy MAC Management - REMOTE

Job Description

Pharmacy Network MAC Management Specialist

Locations : 100% Remote from AL, AZ, CT, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA MI, MN, MO, MS, NC, NE, NV, OH, OK, OR, SC, TN, TX, UT, VT, WI

Get To Know The Team :

The Pharmacy Network Specialist is responsible for network pricing models and MAC management including evaluating financial guarantees and network pricing strategies for existing and potential customers.

They are responsible for ad hoc reporting and innovative tools that streamline client decisions, add value to new and existing clients as they add to or enhance their network models.

This role supports pharmacy operations and frequently interacts with senior leadership. You will join a small, collaborative team promoting better health and financial outcomes for consumers through the integration of advanced analytics, clinical insights, and transformative digital capabilities.

Why You Will Love It Here!

• Flexibility : Hybrid Work Model & a Business Casual Dress Code, including jeans
• Your Future : 401k Matching Program, Professional Development Reimbursement
• Work / Life Balance : Flexible Personal / Vacation Time Off, Sick Leave, Paid Holidays
• Your Wellbeing : Medical, Dental, Vision, Employee Assistance Program, Parental Leave
• Diversity & Inclusion : Committed to Welcoming, Celebrating and Thriving on Diversity
• Training : Hands-On, Team-Customized, including SS&C University
• Extra Perks : Discounts on fitness clubs, travel and more!

What You Will Get To Do :

• Support the Pharmacy Network operations by managing all SS&C MAC Lists including developing strategies, pricing and balancing pharmacy contracts with customer guarantees
• Work with leadership on identifying Network Risk and available mitigation strategies
• Address and respond to MAC appeals meeting all state and other related regulatory requirements
• Create ad hoc reporting for network management and strategic analysis
• Ensure issues are identified, tracked, reported on and resolved in a timely manner
• Involvement in special projects, communication and overall organizational changes related to Pharmacy Networks
• Capacity to embrace change and quickly adapt to new situations, changes in direction, and altering priorities
• Identify Organization's strengths and weaknesses with regards to Pharmacy Networks and suggest areas of improvement
• Involvement in projects related to network management
• Partnering with other internal clients such as contract and legal teams to expedite the client contracting process
• Collaborate with other members of the finance team in budget, forecast, and compliance decisions
• Support the other internal teams and customers in developing Network strategies and responding to customer RFP inquiries

What You Will Bring :

• Degree in Business, Mathematics, Pharmacy, Actuarial Science or other related area or equivalent work-related experience
• Must have 3+ years’ experience in Pharmacy Network MAC Management and Pharmacy Benefit Manager (PBM) experience
• Must be able to understand and evaluate risk
• 1+ years’ experience with modeling and data management
• Advanced SQL, DB Visualizer and Excel skills required
• Tableau experience a plus
• Strong organizational and decision-making skills with a high degree of mathematical aptitude
• Strong understanding of pharmacy network processes
• Excellent written and oral communication skills
• Attention to detail
• Ability to interact with senior management and key business users
• Demonstrated ability to multi-task
• Experience with supporting and managing contractual guarantees
30+ days ago