PBM Call Center Manager

This is a fully remote position, open to applicants in Alabama.

📋 Description

• Oversee daily operations of the PBM call center

• Ensure that service levels, productivity, quality, and customer experience targets are met

• Lead, mentor, and nurture supervisors and customer service teams

• Monitor and assess SLAs, KPIs, quality metrics, customer satisfaction, and operational trends

• Guarantee adherence to Medicaid, HIPAA, PBM, contractual, and regulatory standards

• Manage workforce planning, staffing, scheduling, training, and operational readiness

• Collaborate with clients, pharmacies, providers, state stakeholders, and internal teams to address escalations

• Resolve service challenges and implement process enhancements

• Utilize operational data and performance metrics to identify trends, bridge service gaps, and promote continuous improvement

• Work alongside a geographically distributed healthcare operations team and healthcare stakeholders

⛳️ Requirements

• A minimum of three (3) years of experience in healthcare, Medicaid, PBM, pharmacy, or related healthcare operations

• Proven leadership experience managing teams in a high-volume call center or contact center setting

• In-depth understanding of call center operations, including SLAs, KPIs, quality management, workforce planning, performance management, and customer experience

• Familiarity with NCPDP standards

• Knowledge of healthcare regulatory and compliance obligations

• Strong analytical, communication, problem-solving, and leadership competencies

• Ability to analyze data and convert findings into operational enhancements

• Medicaid/PBM experience is highly preferred

• At least five (5) years of leadership experience in a call center is preferred

• Experience with pharmacy claims, prior authorization, Lean Six Sigma, project management, and/or Pharmacy Technician certification is advantageous

🏝️ Benefits

• Comprehensive medical, dental, and vision coverage

• 401(k) retirement savings plan

• 401(k) employer match

• Employee wellness benefits

• Financial benefits

• Professional development opportunities

• Career growth opportunities

• Educational assistance

• Flexible vacation policy

• Leadership and technical development academies

• Work flexibility

• Learning and career development