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RxSense

PBM software platform with real-time analytics

Manager of Pricing

Corporate Finance & FP&AConfirmed live in the last 24 hours
Full-timeRemote in USA$110k - $140kRemote

About the Job

Requirements

  • Hands-on experience owning maximum allowable cost (MAC) management in a pharmacy benefit manager or pharmacy setting, including 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.
  • At least 5 years of PBM or retail pharmacy pricing experience, including direct MAC management, with at least 2 years in a supervisory or lead capacity, or an 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 credible resource to the business on pricing decisions.
  • Experience leading, coaching, or mentoring analysts and building documented, repeatable processes.
  • Advanced Excel skills.

Responsibilities

  • Own MAC management for the Enterprise book by creating, maintaining, and updating client-specific and dedicated MAC lists to ensure 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 address them before year-end reconciliation.
  • Build and administer pricing for new and renewing clients, partnering with Client Experience and implementation teams to ensure 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 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 inbound pricing requests, set 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 affecting pharmacy networks, formularies, 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.

Desired Qualifications

  • Experience with SQL, Tableau, or other business intelligence tools.
  • Experience adopting automated or AI-enabled pricing tools as a business owner, rather than necessarily as a builder.
  • Experience in a high-growth healthcare technology company.

About the Company

RxSense

PBM software platform with real-time analytics

RxSense provides software solutions for the pharmacy benefits management (PBM) industry. Its core product is an enterprise platform that unifies PBM operations with real-time business intelligence and analytics, enabling clients to monitor performance, optimize models, and make data-driven decisions. The platform is modular and includes APIs that enable interoperability via standards like FHIR and NCPDP, supporting integration with other systems and speeding time to market through optional business accelerators. Real-time data, ad hoc reporting, and analytics help PBMs manage claims adjudication and improve care delivery. Compared with competitors, RxSense emphasizes a real-time, modular platform with ready-to-use accelerators and a strong emphasis on API interoperability to connect diverse healthcare systems. The company’s goal is to simplify complexity in PBM operations, improve efficiency, and empower clients with timely insights to run their benefits programs more effectively.

Company size
201-500
Company stage
Growth Equity (Venture Capital)
Total funding
Not listed
Headquarters
Boston, MA
Founded
2015

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