Leo began his career with the Washington State Department of Social and Health Services (DSHS) and held various direct service, policy, and leadership positions.

As the Director for Community Services, he managed Washington's public assistance system (60 field offices, 3,000 staff) providing Medicaid and other safety net services to more than 1.5 million. Leo spearheaded the business process redesign (BPR) efforts to transform service delivery of these programs, which resulted in new levels of productivity, performance, and cost savings. In 2010, Leo joined Change & Innovation Agency and has led BPR efforts in more than 30% of the states.