Pricing Manager

Job not on LinkedIn

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $110k - $140k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Pricing Analyst

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RxSense

WebsiteLinkedInAll Job Openings

201 - 500 employees

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Private Equity Round on 2020-05

Consulting • Logistics • Healthcare

RxSense is a HealthTech company dedicated to modernizing pharmacy benefit management. They develop cutting-edge products that optimize claims adjudication and analysis, aiming to lower costs and improve access within the pharmacy ecosystem. RxSense offers solutions for PBMs, pharmacies, pharma manufacturers, payers, and consumers, supporting better outcomes for millions of people daily. Their products include advanced tools like the RxIQ Enterprise adjudication engine, business intelligence analytics platform, and AI-based pricing optimization. They are known for their flagship prescription savings brand, SingleCare, which helps consumers secure affordable prices while benefiting pharmacy partners.

📋 Description

• 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 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. • Success includes reliable documented MAC management, tracked client and pharmacy guarantees, clear pricing strategy and turnaround expectations, and regular use of automated pricing tools.

🎯 Requirements

• Hands-on experience owning MAC management in a PBM or pharmacy setting: building and maintaining MAC lists, managing MAC factor adjustments, and quality-checking pricing before it goes live. • Bachelor’s degree in finance, Business, Economics, or a related field. • 5+ years of PBM or retail pharmacy pricing experience, including direct MAC management, with at least two years in a supervisory or lead capacity; or equivalent combination of education and experience. • Working knowledge of PBM pricing economics, including client and pharmacy contract terms, pricing guarantees, and reconciliation. • Experience monitoring pricing performance against guarantees and turning variance into corrective pricing actions. • Experience setting up pricing for client implementations and renewals on tight timelines. • Ability to explain pricing clearly to non-technical partners and serve as a steady, credible resource to the business on pricing decisions. • Experience leading, coaching, or mentoring analysts and building documented, repeatable processes. • Advanced Excel skills. • SQL, Tableau, or other BI tools experience is preferred. • Experience adopting automated or AI-enabled pricing tools as a business owner, not necessarily as a builder is preferred. • Experience in a high-growth healthcare technology company is preferred.

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