Care Operations Associate

Leap Health, Inc.; United States; On-site; USD 60,000 - 95,000; Full time

Benefits offered by this job

Fully remote

Competitive salary

Health coverage

401(k) plan

Ground-up infra build

Job summary

Leap Health, Inc. is seeking a Care Operations Associate to serve as the operational backbone of member activation. You’ll ensure every step from member enrollment to treatment is executed accurately and rapidly, building back-office workflows to scale with growth.

You’ll connect with provider offices, payers, and pharmacy partners, reporting to the Head of Member Ops & Strategy. This role suits a highly organized, process-minded operator who thrives on systemizing procedures.

Qualifications

• 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.

Responsibilities

• Run benefit eligibility checks to confirm coverage, cost-share, and authorization requirements before care begins.
• Manage medical prior authorization requests, renewals, and extensions across payers and specialty pharmacy partners end to end.
• Process incoming referrals, faxes, and clinical documents, routing each to the right place.
• Chase down unsigned documents and orders—follow up proactively with provider offices.
• 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 on time.
• Answer inbound calls from providers, pharmacy partners, and members, triaging and routing inquiries.

Skills

Healthcare operations

Prior authorization

Eligibility verification

Tools

CRM systems

EHR platforms

Documentation management

Job description

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 elevate 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.