This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Care Operations Associate based in United States.
Join a mission-driven healthcare team where your operational expertise will directly support patients in accessing essential treatments. In this fully remote role, you'll oversee the administrative processes that ensure care journeys move forward smoothly, accurately, and without unnecessary delays. Working closely with providers, payers, pharmacy partners, staffing agencies, and internal clinical teams, you'll play a key role in coordinating care while improving operational efficiency. This position is ideal for someone who enjoys building structured processes, managing complex workflows, and making a meaningful impact through exceptional organization and attention to detail in a fast-growing healthcare environment.
Accountabilities:
- Verify member eligibility and insurance benefits, confirming coverage, authorization requirements, and cost-sharing details before treatment begins while maintaining accurate records throughout the care journey.
- Manage prior authorization requests, renewals, and extensions by preparing documentation, tracking approvals, proactively following up with payers and pharmacy partners, and escalating issues that could delay patient care.
- Coordinate the collection of medical orders, referrals, clinical documentation, and provider signatures, ensuring all records are complete, properly routed, and compliant with internal standards and HIPAA requirements.
- Organize clinical staffing schedules and coordinate medication shipments with external partners to ensure treatments are delivered on time.
- Provide professional inbound support for healthcare providers, pharmacy partners, and members by triaging inquiries, documenting interactions, and ensuring timely resolution of action items.
- Develop, document, and continuously improve operational workflows, transforming manual administrative processes into scalable, repeatable systems that support organizational growth.
Requirements
- At least 2 years of experience in healthcare administration or operations, with hands-on involvement in prior authorization, insurance verification, or eligibility processes.
- Strong knowledge of payer portals, authorization workflows, appeals, and healthcare administrative procedures.
- Experience using CRM, EHR, document management, and fax systems within a healthcare environment.
- Proven ability to manage large volumes of detailed administrative work while maintaining exceptional accuracy and organization.
- Experience collaborating with provider offices, insurance payers, pharmacy partners, staffing agencies, and cross-functional internal teams.
- Excellent communication, time management, and problem-solving skills, with the ability to work independently in a fully remote environment during Central Time business hours.
- Preferred qualifications include clinical certifications (such as CMA, RMA, CPhT, or LPN), experience in specialty or home infusion, rare disease programs, healthcare startups, or Spanish language proficiency.
Benefits
- Competitive salary.
- Fully remote work environment.
- Comprehensive medical, dental, and vision insurance.
- 401(k) retirement savings plan.
- Opportunity to help build and improve operational processes within a rapidly growing healthcare organization.
- Meaningful work that directly improves patient access to life-changing treatments.
- Collaborative, mission-driven culture focused on innovation and operational excellence.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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