This is a fully remote role. 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.

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.90

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• 1+ years of professional work experience
• 1+ years MS Office experience

Preferred Qualifications
Experience with RxClaim

Education
High School or GED

Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.