Care Operations Specialist

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

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