Care Operations Manager

Job Summary

To support a growing team, the full-time Care Operations Manager will build SLAs, KPIs, and workflows for eligibility, prior authorization, and partner coordination while managing a team of Care Operations Associates in a remote environment.

Key Responsibilities

• Hire, train, and manage Care Operations Associates, handling complex cases as a player-coach
• Build and enforce SLAs and KPIs, designing initial QA processes and core workflows
• Manage relationships with specialty pharmacies and staffing agencies, ensuring accountability to SLAs

Required Qualifications

• 4-8+ years in specialty pharmacy, payer, or provider-side operations with hands-on experience in key areas
• Direct experience with prior authorization denials and appeals
• Track record of building or managing SLAs/KPIs for operations teams
• Experience managing external vendor relationships and resolving escalations
• Demonstrated ability to build or redesign workflows from the ground up