Manager,CaseManagement

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. Primary 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 Qualifications Clinical background in care management, utilization management, pharmacy-related clinical programs, or similar healthcare operations 2+ ye