Care Operations Manager

About Leap

Leap is a rapidly expanding benefits solutions provider pioneering employer specialty pharmacy services. Our mission is to transform how critical therapies are delivered and funded, ensuring patients receive necessary treatments and employers achieve fair pricing. Specialty drugs and infusions constitute nearly 10% of healthcare expenditures and represent the fastest-growing cost sector for employers. Leap confronts this issue by removing hidden markups, broadening access to quality infusion providers, and creating transparency in therapy pricing and payment.

We collaborate with several Fortune 500 companies and premier third-party administrators (TPAs) to generate immediate returns on investment through cost reductions, enhanced accessibility, and improved patient care. Join us as we redefine specialty care possibilities.

Role Overview

As Leap scales its Care Operations team, the Care Operations Manager role is critical for establishing service level agreements (SLAs), key performance indicators (KPIs), and workflows for eligibility verification, prior authorization, documentation, and partner coordination that are currently lacking. This manager will ensure operational discipline, develop management rhythms, implement quality assurance (QA) procedures, and design tracking systems monitoring funnel throughput and velocity.

The position involves close collaboration with Intake Coordinators, the Engineering and Data teams, and direct partnership with specialty pharmacies and staffing agencies to enforce SLA adherence. Reporting to the Head of Member Operations and Strategy, the role begins with hands-on management of complex cases and transitions into leading a growing Care Operations Associates team through segmentation and scaling.

Key Responsibilities

• Recruit, train, and oversee Care Operations Associates, creating regular management routines and feedback mechanisms.
• Manage the most challenging and escalated cases personally, such as denied prior authorizations, missing documentation, and provider conflicts, especially during initial launch phases.
• Organize the team into specialized subgroups for functions like orders, prior authorizations, and staffing as headcount approaches 10 associates.
• Develop and implement SLAs and KPIs for eligibility checks, prior authorizations, documentation, and partner coordination.
• Initiate and maintain QA processes to confirm workflow integrity under live case volumes before broader launch.
• Design or overhaul key workflows, leveraging case-specific metrics to promote coaching over routine reporting.
• Manage relationships with specialty pharmacies, ensuring partner compliance with shipment schedules and SLA commitments.
• Coordinate multi-state nursing and staffing agency partnerships, addressing staffing issues and escalations.
• Define communication protocols for issue resolution and relationship building among logistics, staffing, and pharmacy partners.
• Collaborate with Engineering to specify and develop automation for partner workflow requests.
• Work with the Data team to create real-time dashboards tracking funnel progress and performance metrics.
• Coordinate with Intake Coordinators regarding consent form volumes entering member activation.

Qualifications

Required

• Between 4 and 8+ years of experience in specialty pharmacy, payer, or provider-side operations with direct involvement in at least three areas such as eligibility verification, prior authorization, insurer coordination, document management, or provider relations.
• Direct hands-on experience managing prior authorization denials and appeals.
• Proven success in developing and maintaining SLAs/KPIs to drive team performance and coaching.
• Experience managing external vendor relationships, including specialty pharmacies and nursing or staffing agencies, ensuring adherence to SLAs and resolving escalations.
• Background in leading teams through launches, surges in volume, or rapid expansion.
• Ability to design or significantly redesign workflows starting from scratch.
• Comfort managing functions with audit-ready documentation and compliance standards relating to protected health information (PHI), consent forms, and dispensing records.

Preferred

• Specific expertise in specialty pharmacy or home infusion services.
• Experience with self-insured employers or employer-sponsored healthcare plans.
• Active clinical licenses such as RN, PharmD, or LPN.
• Experience coordinating nursing agencies across multiple states.
• Background in healthcare startups or rapidly scaling care-delivery organizations.

Additional Information

This role is integral to building a high-impact, focused team at Leap. The company values diversity and invites qualified candidates from all backgrounds to apply.

Compensation Range: $80,000 to $110,000 per year.