Care Operations Manager
Job Description
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About the Role
Leap is scaling its Care Operations and this role exists to build the SLAs, KPIs, and workflows that don't yet exist for eligibility, prior authorization, documentation, and partner coordination. The Care Operations Manager owns the team's operational rigor, setting a management cadence, standing up QA processes, and building the tracking that shows funnel velocity and throughput. This person works closely with Intake Coordinators, Engineering, and the Data team, and partners directly with specialty pharmacies and staffing agencies to hold external vendors to SLA. Reporting to the Head of Member Operations and Strategy, they'll start as a hands-on player-coach on the highest-stakes cases and shift over the first year into a manager leading a growing team of Care Operations Associates through segmentation and scale.
Key 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
Qualifications
Required
- 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)
Preferred
- 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.
Leap is an equal opportunity employer and welcomes applicants from all backgrounds. We’re committed to building a team that reflects a diversity of perspectives, experiences, and identities.
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Leap Health
View Company ProfileLeap Health is a premier, enterprise-grade specialty infusion care platform, digital health benefits coordinator, and clinical operations innovator engineered to operate as the definitive home-based treatment layer for employer-sponsored health plans and complex chronic disease patients across North America. The company completely eliminates the severe systemic friction, exorbitant drug markups, and geographic inconveniences of traditional specialty infusion care—where patients suffering from chronic neurological, gastroenterological, and rheumatological conditions are forced to lose travel days, compromise employment velocity, and navigate opaque hospital pricing architectures—by deploying an integrated, patient-first decentralized delivery network. Moving far beyond traditional, passive healthcare brokerages or clinical staffing registries, Leap Health natively unifies dedicated personalized care guidance workflows, automated benefit eligibility checking modules, flexible evening and weekend appointment scheduling infrastructures, and high-quality medication delivery protocols into a single high-availability operational ecosystem. The institution empowers self-insured employers and benefits consultants to slash unnecessary specialty drug spends by up to 60% through the elimination of inflated hospital markups, while simultaneously elevating patient adherence and clinical satisfaction. Under the hood, its sophisticated technical core coordinates secure, two-way physician communication loops, multi-region compliance verification arrays, and an elite network of licensed infusion nurses to safely administer more than 200 complex specialty therapeutics—such as Ocrevus, Remicade, and Entyvio—directly within the comfort of a patient's home. What sets Leap Health apart is its uncompromising dedication to replacing ancient, hospital-centric monopolies with streamlined clinical momentum; by bridging the gap between performance-intensive specialty pharmaceutical tracking and absolute human convenience, the firm delivers exceptional, transparent clinical care that transforms the modern healthcare benefits landscape.
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