Pharmacy Benefit Operations Supervisor

Point C

10d•$75,000 - $76,000

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. 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.

Requirements

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.

Nice To Haves

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

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.