Care Operations Specialist

Care Operations Specialist 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 Specialist supports the operational workflows that enable Leap’s clinical team to deliver high-quality member care. This role owns key administrative processes that ensure clinical operations are ready to activate members for treatment, including benefits verification, prior authorization tracking, provider coordination, and documentation management. By ensuring these processes are completed accurately and on time, the Care Operations Specialist helps enable timely member activation and a smooth care experience. You will work closely with Care Guides, clinical leadership, pharmacy partners, provider offices, and payers to coordinate the information required for treatment readiness. This role reports to the Care Guide Clinical Manager. KEY RESPONSIBILITIES Prior Authorization & Eligibility Operations - Track and manage prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners - Prepare and submit prior authorization documentation and monitor approval status - Verify member eligibility and benefits to confirm coverage requirements for care initiation Maintain accurate records of authorization and eligibility status within Leap’s CRM/EHR systems Provider Coordination - Contact provider offices to obtain updated orders and clarify documentation requirements - Track outstanding provider requests and follow up proactively to prevent delays in care - Coordinate communication between provider offices, specialty pharmacies, and Leap’s clinical team Documentation & Operational Support - Upload, organize, and maintain member records and clinical documentation accurately and in a timely manner - Process incoming referrals, faxes, and documentation and route materials to the appropriate care team members - Ensure documentation meets internal standards and HIPAA compliance requirements Inbound Call Support - Answer inbound calls from providers, pharmacy partners, and occasionally members and route inquiries appropriately - Document call details and ensure timely follow-through on related action items - Represent Leap with professionalism and a service-oriented approach during all interactions QUALIFICATIONS Required: - 2+ years of experience in a healthcare administrative or operations role supporting prior authorization or eligibility verification processes - Familiarity with payer portals, prior authorization documentation workflows, and follow-up or appeal processes - Proficiency with CRM or EHR systems and document management platforms including fax - Proven ability to manage high volumes of administrative tasks with accuracy and attention to detail. - Comfortable coordinating across provider offices, payers, pharmacy partners, and internal clinical teams - Strong organizational and communication skills in a fast-paced operational environment - Ability to work independently during CST business hours in a fully remote setting. Preferred: - Clinical certification or licensure (CMA, RMA, CPhT, LPN, or similar) - Experience in a healthcare startup or high-growth e ... (truncated, view full listing at source)