MAC Program Specialist II – Case Management & Appeals

Cencora; Orange (CA); Hybrid; USD 68,770,000 - 74,501,000; Full time

Job summary

Cencora seeks a MAC Program Support Rep II to manage the end-to-end MAC lifecycle within its US distribution services. You will handle intake, data entry, PBM submissions, appeals, and customer reporting to optimize outcomes for member pharmacies.

In this role, you will serve as the subject matter expert and escalation point, ensuring timely resolution, accurate case management, and collaboration with IT, operations, and PBMs. This is a hybrid in Orange, CA with a daytime Monday–Friday schedule.

Qualifications

• High School Diploma/GED or equivalent required.
• 3+ years of experience in customer systems support, customer operations, service operations, order management, case management, or a related field required.
• Certification in IT service management, customer support, customer relationship management systems, process improvement, or equivalent certification preferred.

Responsibilities

• Receives, identifies, and triages all MAC requests submitted via the MAC mailbox.
• Performs daily data entry of all MAC requests, additions, and updates.
• Submits weekly research requests to PBMs; tracks and follows up on open items.
• Manages the MAC mailbox, ensuring timely response and queue hygiene.
• Creates, updates, and closes MAC cases in the applicable system(s).
• Monitors case aging and prioritizes pending review queue to minimize backlog.
• Updates MAC cases based on PBM responses; documents outcomes for audit and reporting.
• Submits MAC appeals to PBMs within required timeframes; tracks status and outcomes.
• Challenges unfavorable MAC responses using program data and appeal pathways.

Skills

MAC program management

PBM submissions

Data entry

Education

High School Diploma/GED

Certification in IT service management (preferred)

Job description

Cencora seeks a MAC Program Support Rep II to manage the end-to-end MAC lifecycle within its US distribution services. You will handle intake, data entry, PBM submissions, appeals, and customer reporting to optimize outcomes for member pharmacies.

In this role, you will serve as the subject matter expert and escalation point, ensuring timely resolution, accurate case management, and collaboration with IT, operations, and PBMs. This is a hybrid in Orange, CA with a daytime Monday–Friday schedule.