Note: The job is a remote job and is open to candidates in USA. Point 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.
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
Skills
- 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
- 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 Overview
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