Care Operations Manager

🕒 vor 1 Monat

🇺🇸 Vereinigte Staaten – Remote

💵 $80.000 - $110.000 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

⚙️ Operations

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 17%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Leap

Leap

11 - 50 Mitarbeiter

Gegründet 2023

🛡️ Versicherung

💼 Beratung

🏥 Gesundheitswesen

💰 €1.000.000 Venture Round - LEAP HEALTH im 2024-03

Insurance • Consulting • Healthcare

Leap ist die einzige transparente Spezialinfusions-Lösung für Arbeitgeber. Sie eliminiert versteckte Medikamentenaufschläge und bietet durchgehende Koordination der Spezialinfusionspflege - von der Apothekenbeschaffung bis zur Pflege zu Hause - um die Kosten für Spezialmedikamente zu senken und die Patientenerfahrung zu vereinfachen. Leap bedient selbstfinanzierte Arbeitgeber, Makler/Berater und Patienten mit einem technologiegestützten Pflegemodell, das die Infusionsausgaben senkt, das Engagement verbessert und jährliche Einsparungen bringt.

Beschreibung

• 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

🎯 Anforderungen

• 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)

🏖️ Vorteile

• Offers Equity

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