PCRX Care Navigator

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 Nurse Care Navigator – Drug Optimization & Pharmacy Coordination is a licensed nurse responsible for coordinating and overseeing case management services related to medication optimization, international drug sourcing, and pharmacy benefit management (PBM) collaboration. This role serves as a clinical liaison among members, PBMs, international sourcing partners, providers, and internal teams to ensure safe, cost effective, and clinically appropriate medication use.

Coordinate case management activities related to medication optimization, adherence, and therapeutic appropriateness Review medication regimens and clinical documentation to identify optimization opportunities Collaborate with providers, PBMs, and pharmacy partners to support evidence-based medication use and access Support specialty and high-cost medication coordination initiatives Coordinate international drug sourcing programs, including partner collaboration, member education, and continuity of care Serve as a clinical liaison across PBMs, pharmacy vendors, and internal teams to align on formulary options and access strategies Conduct member outreach, education, and follow-up to support adherence and understanding Review clinical records, pharmacy data, and provider documentation; escalate complex cases as needed Ensure compliance with nursing scope of practice, regulatory requirements, and organizational policies Maintain accurate and timely clinical documentation