Manager, Case Management

Point C

11h•$90,000 - $100,000

About The Position

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. The Manager, Case Management is responsible for providing dedicated clinical leadership and operational oversight for PCRX clinical services. This role ensures standardized workflows, consistent clinical quality, effective staff management, and scalable operations. The Manager serves as the primary point of accountability for PCRX clinical performance, supporting sustainable growth while reducing operational risk.

Requirements

Clinical background in care management, utilization management, pharmacy-related clinical programs, or similar healthcare operations
2+ years of clinical leadership or people-management experience
Strong understanding of clinical workflows, training models, and quality management
Demonstrated ability to standardize processes and lead operational change
Excellent communication, organizational, and problem-solving skills

Nice To Haves

Experience managing pharmacy-adjacent or medication-focused clinical programs preferred
Experience scaling clinical operations or maturing start-up operational models preferred
Familiarity with utilization guidelines, clinical decision support tools, or structured review frameworks preferred

Responsibilities

Oversee, coach, and manage performance of PCRX clinical staff
Serve as the primary clinical escalation point for operational and workflow issues
Foster a culture of accountability, quality, and continuous improvement
Develop and maintain standardized workflows, policies, and procedures for PCRX clinical activities
Identify inefficiencies and gaps; implement corrective actions and process improvements
Own onboarding, training, and competency validation for PCRX clinical staff
Ensure staff are trained on workflows, tools, documentation standards, and internal guidelines
Monitor clinical quality, documentation consistency, and adherence to internal standards
Support audit readiness and quality review activities
Provide data-informed recommendations to leadership on staffing, workflow, and capacity needs