Care Operations Manager

🕒 il y a 14 jours

🇺🇸 États-Unis – Télétravail

💵 $80 000 - $110 000 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

⚙️ Opérations

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Leap

Site WebLinkedInTous les Emplois

11 - 50 employés

Fondée en 2023

🛡️ Assurance

💼 Conseil

🏥 Santé

💰 €1 000 000 Venture Round - LEAP HEALTH en 2024-03

Insurance • Consulting • Healthcare

Leap est la seule solution transparente de gestion des prestations d’infusion spécialisée pour les employeurs. Elle élimine les majorations cachées sur les médicaments et offre une coordination complète des soins d’infusion spécialisés, depuis l'approvisionnement pharmaceutique jusqu'aux soins infirmiers à domicile, afin de réduire les coûts des médicaments spécialisés et de simplifier l'expérience du patient. Leap dessert les employeurs autofinancés, les courtiers/consultants et les patients avec un modèle de soins activé par la technologie qui réduit les dépenses d'infusion, améliore l'engagement et offre des économies substantielles dès l'année en cours.

Description

• 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

🎯 Exigences

• 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)

🏖️ Avantages

• Offers Equity