Point C · 1 week ago
Pharmacy Benefit Operations Supervisor
United States
Full-time
Remote
Entry, Mid Level
$75K/yr - $76K/yr
1+ years expPoint C is a National third-party administrator (TPA) focused on delivering customized self-funded benefit programs. They are seeking a Pharmacy Solutions Operations Supervisor to oversee pharmacy member support operations, manage phone queues, and ensure a high-quality member experience.
Health CareHealth InsuranceHospital
Responsibilities
Oversees and manages pharmacy phone queue, ensuring exceptional member experience, appropriate documentation, and effective customer service
Tracks key performance indicators and provides reports to manager in a timely manner
Maintains reasonable member satisfaction goals and works with the team to meet them
Interacts with members should calls need to be escalated to management
Onboards new employees and trains them based on their expertise and skill set
Proactively identifies potential member disruption
Answer inbound calls and return voicemails from members, delivering exemplary customer service and support
Troubleshoot and resolve prescription-related issues for members whose plans utilize CVS or Carelon as the PBM
Coordinate with providers’ offices and retail/mail-order pharmacies as needed to resolve claims processing, prior authorization, and medication access issues
Document all actions, progress, and communication in the ticketing system and Acuity, updating ticket status in accordance with internal standards
Conduct proactive member outreach, including but not limited to disruption list communications and follow-up calls
Collaborate closely with Pharmacy Services team members and cross-functional departments to ensure timely resolution of pharmacy-related concerns
Perform other duties as assigned
Qualification
Required
Active or eligible Pharmacy Technician license/certification (state-specific requirements apply). National Certification is preferred
1–2+ years of experience in a pharmacy on the health plan/carrier side
Strong understanding of pharmacy operations, prescription workflows, and medication terminology
Excellent verbal and written communication skills, with the ability to deliver clear and compassionate support
Proficient in navigating systems such as ticketing platforms, pharmacy software, or claims tools (experience with Acuity is a plus)
High attention to detail, strong organizational skills, and ability to manage multiple priorities in a fast-paced environment
Commitment to confidentiality, accuracy, and a positive member experience
Preferred
Experience troubleshooting pharmacy or claims issues with PBMs such as CVS, Carelon, Optum, or Express Scripts
Benefits
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Company
Point C
Point C is a network of self-insured healthcare plan third-party administrators.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Shore Capital Partners
2024-11-19Series Unknown
Leadership Team
Ben Frisch
Chief Executive Officer
William Mcnally, CPA
Chief Financial Officer
Recent News
Venture Capital Access Online
2024-11-21
2024-02-03
2024-01-04
Company data provided by crunchbase