Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The MAC team is responsible for all aspects of MAC list maintenance. This includes creating new MAC lists and managing existing MAC lists, uploading MAC prices to the adjudication platform and all MAC related QC processes. The MAC team works closely with the Finance Guarantee team to help ensure client commitments are met by making MAC adjustments as appropriate. The MAC team is also responsible for reviewing and responding to all pharmacy MAC appeals and working with the Legal team to respond to any MAC related complaints from state agencies. In addition, the MAC team monitors pharmacy GER guarantees and making MAC adjustments as needed. The MAC team is also responsible for all MAC related reporting, including client and pharmacy reports.

Responsibilities include

- Reviewing and resolving MAC pricing inquiries from pharmacies (both MAC law states and non-MAC law states) and comply with MAC law requirements.

- Validating information from various sources such as Medispan, manufacturers and wholesalers.

- Accurately update Pharmacy Inquiry Database with appropriate information and respond to pharmacies within required TAT.

- Identify marketplace condition changes and quickly forward potential issues to pharmacists for review in order to minimize impact to pharmacies and plan members.

- Maintain MACPRICE email box and respond to pharmacy phone calls as required by state laws.

Required Qualifications

- 1 plus years of professional work experience

- 1 plus years MS Office experience

Preferred qualifications

- Experience with RxClaim

- Bachelor’s Degree

- Access Database

- SAS

- Bachelor Degree

Education

High School or equivalent GED

Pay Range

The typical pay range for this role is:

$17.00 - $31.30

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/22/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.