Care Operations Associate
Core
Operational backbone for member activation, ensuring administrative steps between enrollment and treatment are completed accurately and fast.
Role type
Senior IC healthcare operations associate (specialty pharmacy)
Builds
Back-office processes for eligibility, prior authorization, and care coordination
Domain
Healthcare / Specialty Pharmacy / Infusion
Required skills
Prior authorization management, benefit eligibility verification, document follow-up, staffing coordination, medication shipping coordination, inbound call triaging, HIPAA compliance, workflow design, CRM/EHR proficiency, high-volume detail management
Preferred skills
Clinical certification (CMA, RMA, CPhT, LPN), startup/high-growth experience, specialty infusion program experience, Spanish fluency
Technologies
CRM, EHR, document management platforms, fax
Responsibilities
Run benefit eligibility checks and maintain accurate status; manage medical prior authorization requests end-to-end; chase unsigned documents and process referrals/faxes; coordinate clinical staffing and medication shipping; answer inbound calls and triage inquiries; collect and store member records ensuring HIPAA compliance; design and improve operational workflows