Empleos de documentation en San Juan

Regular Non-Exempt **General Description** Responsible for managing and performing key tasks within the recruitment process, with a focus on onboarding, contracting, and compliance. This position acts as a bridge between the Talent Acquisition team and new employees, ensuring an efficient and positive experience. The role includes administrative...

Regular Exempt **GENERAL DESCRIPTION:** Supports regulatory compliance through audit readiness, regulatory reviews, corrective action plan management, and monitoring of provider network activities, including contracting, credentialing, and recredentialing. Responsible for monitoring and analyzing metrics, key performance indicators (KPIs), and...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for conducting pharmacy audit, monitoring, and compliance activities to ensure adherence to the Center of Medicare and Medicaid Services (CMS) regulations, contractual requirements, and organizational standards across all Lines of Business (LOBs). Oversee Pharmacy Benefit Management (PBM)...

Regular Exempt **GENERAL DESCRIPTION:** Assists in investigating cases for resolution in compliance with the applicable regulations, guidelines, and contractual agreements. Participates in the implementation processes of the special networks, prompt payment, and directory complaints, which entails analyzing the operational impact, validations,...

Regular Non-Exempt **GENERAL DESCRIPTION:** Provides first-level technical support to internal and external customers by responding to service requests, answering inquiries, resolving or escalating technology-related issues, and ensuring timely follow-up. Troubleshoots hardware, software, and system problems, documents incidents and requests, and...

The Advisor, Marketing (Developer) executes, implements, and optimizes marketing technology solutions that enable automated, data-driven customer engagement across acquisition and lifecycle programs. This role translates strategic business requirements into scalable workflows, system integrations, customer journeys, and technical capabilities that support...

Regular Exempt **GENERAL DESCRIPTION:** Serves as a liaison between the company and extended care home administration to coordinate, refer, and manage documents and/or services related to the company’s Home Health Program. Responsible for handling, channeling, and resolving service situations related to complaints, claims, and operational...

Regular Exempt **GENERAL DESCRIPTION:** Represents the company in official service negotiations with assigned group. Attend, channel, and solve the different situations from customers, underwriters, and producers as required. Responsible for coordinating and negotiating with the underwriting department the renewal proposal of groups assigned to...

Regular Exempt **GENERAL DESCRIPTION:** Performs health risk assessments (HRA’s) to determine if the member is eligible for Special Supplemental Benefits for the Chronically Ill (SSBCI). Reviews the member's individualized care plan and performs specific interventions to monitor the member's health status. **ESSENTIAL FUNCTIONS:** -...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for the execution, monitoring, and evaluation of clinical pharmacy initiatives to ensure they align with organizational goals, regulatory requirements, and performance standards. Supports the development of cost-effective, patient-centered interventions, analyzes clinical and operational data,...

This role has been designed as 'Hybrid' with a requirement that you will work on average 2 days per week from an HPE office. **Who We Are** Hewlett Packard Enterprise is the global edge-to-cloud company advancing the way people live and work. We help companies connect, protect, analyze, and act on their data and applications wherever they live, from...

Regular Non-Exempt **GENERAL DESCRIPTION:** Calls medical offices to request, receive by fax, and register documents contained in the medical records of Classicare policyholders, as required and according to the different initiatives worked on in the unit. Refers documents received by the medical offices to the Risk Assessment unit, to complete...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for coordinating, routing, and following up on operational requests related to the department and/or unit. Provides administrative support, manages documentation, and ensures compliance with internal processes and regulatory requirements, contributing to operational efficiency and service...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for managing administrative tasks, coordinating services, and maintaining compliance with established protocols. Serves as a vital link between members, healthcare providers, and the multidisciplinary team within the organization. Facilitates the delivery of services to members in an...

**QUANTITATIVE ANALYST** **RISK ASSESSMENT DEPARTMENT** **FIRSTBANK PR** **Our Company** At **FirstBank PR** , we strive to be trusted advisors to our clients and our employees are the ones that ensure we deliver on our promise of excellence in personalized customer service. Our more than 3,100 employees in Puerto Rico, the Virgin Islands and Florida...

**GENERAL DESCRIPTION:** Responsible for answering and making telephone calls to participating and non-participating providers offering services in the service area and outside the plan service area, as well as to policyholders. Guarantees that situations or service needs are solved at the time of the call and, if necessary, refer to their supervisor any...

Regular Exempt **GENERAL DESCRIPTION:** Carries out nursing functions in performing care management process, organizational determinations, and transitional care, including, but not limited to, health assessments, biopsychosocial needs assessment, and barriers for policyholders with medical conditions to develop a comprehensive and customized...

**Job Summary** **JOB DESCRIPTION** The Grant Manager will be responsible for providing support and technical advice to the State and its subrecipients in support of their recovery initiatives to include all facets of launch, implementation, and close out of Disaster Recovery programs, projects, and activities. This position supports clients with procurement...

to provide support to qualification/validation activities related to solid dosage form packaging equipment. Include preparation of (IQ/OQ/PQ) protocols for packaging equipment, execution and documentation of validation studies, review of the raw data and development of the summary reports. Requires cross-functional collaboration with project team and...

The BSA Monitoring Analyst evaluates sensitive information concerning customer account activity including transactional data to prevent and assess if such activity may be potentially linked to unlawful practices related to money laundering, terrorist financing, organized crime, and other financial crime activity in order in order to determine if a subsequent...