Care Operations Associate

ABOUT LEAP Leap is one of the fastest-growing benefits solutions and a category-defining pioneer in employer specialty pharmacy. We are reshaping how life-changing therapies are delivered and financed, ensuring patients get the treatment they need while employers finally get a fair deal. Specialty drugs and infusions represent nearly 10% of all healthcare spend and are the fastest-growing cost category for employers. Leap tackles this challenge with a novel approach: eliminating hidden markups, expanding access to high-quality infusion providers, and bringing clarity and fairness to how therapies are priced and paid for. We’re proud to partner with numerous Fortune 500 companies and leading TPAs. Each patient we serve creates immediate ROI: lower costs, improved access, and better care. Join us as we redefine what’s possible in specialty care. ABOUT THE ROLE The Care Operations Associate is the operational backbone of member activation: the person who makes sure every administrative step between "member enrolled" and "member in treatment" gets done accurately and fast. You'll build and run the back-office processes that free our Care Guides and clinical team to focus on members—and you'll have real ownership to improve how this work gets done. You'll be a critical link between provider offices, payers, pharmacy partners, staffing agencies, and our internal clinical team. This role reports to the Head of Member Ops. & Strategy and is ideal for a highly organized, process-minded operator who thrives when given a problem to systematize. WHAT YOU'LL OWN Benefits & Eligibility - Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins - Keep eligibility status accurate and current for every active member in our systems Prior Authorization - Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end - Prepare and submit PA documentation, track approval status, and escalate stalled or denied authorizations before they delay care Document & Order Follow-Up - Chase down unsigned documents and orders—following up proactively with provider offices so nothing stalls in limbo - Process incoming referrals, faxes, and clinical documents, routing each to the right place Staffing & Shipping Coordination - Coordinate clinical staffing with staffing agencies to ensure providers are in place for each member's treatment - Coordinate medication shipping with pharmacy partners so the right therapy arrives at the right time Inbound Call Support - Answer inbound calls from providers, pharmacy partners, and occasionally members, triaging and routing each inquiry to the right team member - Document call details accurately and follow through on any action items - Represent Leap with professionalism and a service-oriented approach on every call Documentation & Compliance - Collect, organize, and store member records and clinical documentation accurately and on time - Ensure all files meet internal standards and HIPAA compliance requirements Process Building - Design, document, and continuously improve the workflows behind all of the above—turning manual, ad hoc tasks into repeatable systems as we scale WHAT WE'RE LOOKING FOR Required - 2+ years in a healthcare administrative or operations role supporting prior authorization or eligibility verification - Familiarity with payer portals, PA workflows, and follow-up/appeal processes - Proficiency with CRM or EHR systems and document management platforms, including fax - A proven track record managing high volumes of detailed work without dropping the ball - Comfort coordinating across provider offices, payers, pharmacy partners, staffing agencies, and internal teams - Strong organizational and communication skills, and the ability to work independently during CST business hours in a fully remote setting Bonus Points - Clinical certification or licensure (CMA, RMA, CPhT, LPN, or similar) - Experience in a healthcare startup or high-growth environment - Experience in specialty infusion, home infusion, or rare disease programs - Spanish fluency (spoken and written) WHY LEAP - Competitive salary - Fully remote - Competitive health, dental, and vision coverage - 401(k) retirement plan - A rare chance to build operational infrastructure from the ground up at a fast-growing company where your work directly gets patients into treatment At Leap, we’re building an outlier company with real impact — and that takes focus, energy, and commitment. If that excites you, we’d love to hear from you. Leap is an equal opportunity employer and welcomes applicants from all backgrounds. We’re committed to building a team that reflects a diversity of perspectives, experiences, and identities.

• Highlight your experience with specialty pharmacy platforms (e.g., CoverMyMeds, Surescripts) by including a short “tech stack” section on your résumé and be ready to discuss how you used them to verify authorizations, track infusion schedules, or resolve billing discrepancies.
• Create a one‑page case study showing a real or simulated workflow where you reduced claim processing time or eliminated a hidden markup for a high‑cost therapy; quantify the impact (e.g., “cut turnaround from 5 days to 2 days, saving $12K/month”) and bring it to the interview as a PDF or shared Google Doc.
• Demonstrate remote‑team collaboration skills: list the specific communication tools Leap uses (Slack, Zoom, Asana) and give concrete examples of how you coordinated with clinicians, payors, and logistics partners across time zones without sacrificing SLA compliance.
• Prepare to answer scenario questions on “fair pricing” by researching Leap’s pricing model (transparent markup elimination, provider network optimization) and rehearsing a concise explanation of how you would audit a claim for hidden fees and propose a corrective action plan.
• When discussing compensation, reference industry benchmarks for Care Operations roles in specialty pharmacy (e.g., $70‑85K base + performance bonus) and be ready to negotiate a remote‑work stipend for home office equipment, citing Leap’s commitment to supporting distributed teams.