Care Operations Manager

Leap

22d•$80,000 - $110,000

About The Position

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.

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)

Nice To Haves

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

Responsibilities

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
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
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
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