Care Operations Manager

Leap

Care Operations Manager overseeing team management and operational workflows in specialty pharmacy settings. Focused on building SLAs, KPIs, and improving care delivery processes.

Posted 7/24/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $110,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing operations within specialty pharmacy and payer environments, focusing on building and enforcing SLAs and KPIs while ensuring compliance with documentation standards. Proven ability to lead teams through complex workflows and operational challenges, driving performance through data-driven coaching and effective vendor management.

Highest-signal resume keywords

Specialty Pharmacy OperationsPrior Authorization ManagementSLA/KPI DevelopmentVendor Relationship ManagementWorkflow Redesign

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Eligibility VerificationPrior AuthorizationInsurance CoordinationDocument CollectionProvider RelationsData AnalysisQuality AssuranceMetrics TrackingCase ManagementCompliance Standards

Soft Skills

Team LeadershipCommunicationProblem SolvingCoachingConflict Resolution

Tools & Technologies

Live DashboardsAutomation ToolsQA ProcessesWorkflow Management Systems

Industry Keywords

Healthcare OperationsPayer OperationsProvider-Side OperationsAudit-Ready DocumentationPHI Compliance

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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)

Benefits

Comp & perks

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