[Remote] Pharmacy Benefit Operations Supervisor

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