leap - Care Operations Manager
Requirements
• 4-8+ years in specialty pharmacy, payer, or provider-side operations, with hands-on experience across at least 3 of: eligibility verification, prior authorization, insurance/payer coordination, document collection, provider relations • Direct experience personally working prior authorization denials and appeals, not just overseeing others who do • Track record of building or running SLAs/KPIs for an operations team and using those metrics to drive coaching • Experience managing external vendor relationships at scale — specialty pharmacies, nursing/staffing agencies — including holding partners to SLAs and resolving escalations • Experience managing a team through a launch, volume surge, or rapid scale event • Demonstrated ability to build or meaningfully redesign a workflow from the ground up • Comfort owning a function with audit-ready documentation and compliance standards (PHI, consent, dispense records) • Specialty pharmacy or home infusion-specific experience • Experience with self-insured employers or employer-sponsored plans • Active clinical license (RN, PharmD, LPN) • Multi-state nursing agency coordination experience • Healthcare startup or fast-scaling care-delivery background • At Leap, we’re building an outlier company with real impact — and that takes focus, energy, and commitment. If that excites you, we’d love to hear from you.
Responsibilities
• Team Leadership & Management • Hire, train, and manage Care Operations Associates, establishing a management cadence and consistent feedback loop • Personally handle the most complex, escalated cases — denied PAs, missing documentation, provider pushback — as a hands-on player-coach through the 1/1 launch • Restructure the team into functional sub-segments (orders, prior authorizations, staffing requests) as headcount scales toward 10 Care Operations Associates • Process & Performance Management • Build and enforce SLAs and KPIs across eligibility verification, prior authorization, documentation, and partner coordination • Design and run an initial QA process to validate that workflows hold up under real case volume ahead of launch • Build or redesign core workflows from scratch, and use case-level metrics to drive coaching rather than pure reporting • Partner & Vendor Management • Own specialty pharmacy relationships, holding partners accountable to shipment scheduling and SLA commitments • Manage nursing and staffing agency partnerships across multiple states, resolving staffing conflicts and escalations • Set communication standards for issue reporting and rapport-building across LTNs, staffing agencies, and specialty pharmacies • Cross-Functional Collaboration • Partner with Engineering to scope and build automations for partner request workflows • Work with the Data team to build live dashboards tracking funnel velocity, time-in-stage, and throughput • Coordinate with Intake Coordinators on consent-form volume flowing into member activation
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