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Pharmacy Benefit Operations Supervisor

United States - Remote

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

 

Point C is looking for a service-driven and organized Pharmacy Solutions Operations Supervisor to join our team. In this role, you’ll oversee pharmacy member support operations, manage phone queues and escalations, and ensure a high-quality member experience. The ideal candidate has strong pharmacy and PBM knowledge, leadership experience, and the ability to balance operational oversight with hands-on support in a fast-paced environment.

Primary 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.

 

Qualifications:

· 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.

· Experience troubleshooting pharmacy or claims issues with PBMs such as CVS, Carelon, Optum, or Express Scripts (preferred).

· 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.

 

Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.

Pay Transparency

$75,000 - $76,000 USD

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)

 

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

 

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