Empleos de evaluation en San Juan

Regular Non-Exempt **GENERAL DESCRIPTION:** Supports daily unit operations by completing document intake, evaluation, classification, and distribution processes. Provides guidance to technicians, resolves escalated issues, and acts as a liaison between internal and external teams to ensure efficient workflow and service delivery. Monitors...

Regular Exempt **GENERAL DESCRIPTION:** Evaluates utilization in clinical records and hospital facilities concurrently and retrospectively. Identifies and refers to other clinical departments (Case management, condition management, among others) cases for the management of treatment alternatives. Makes efforts to receive advice in difficult...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for receiving, registering, and forwarding applications received within the unit to certify the chronic conditions of beneficiaries for a chronic product. Responsible for the confirmation of chronic conditions for the C-SNP plan members. Enters data from health status and risk factor...

Regular Exempt **GENERAL DESCRIPTION:** The Health Educator is responsible for designing and implementing educational interventions aimed at preventive care, healthy lifestyles promotion and condition management aligned with the goals and objectives of the company’s Wellness Program. **ESSENTIAL FUNCTIONS:** - Design and develop...

**Job Description** **Role Overview** We are looking for a motivated Applied AI Specialist to join our growing Voice AI team. This role suits candidates who combine a solid grounding in software engineering fundamentals with strong testing discipline and a customer-focused mindset. You will initially own feature testing and quality assurance for our Voice...

Regular Non-Exempt **GENERAL DESCRIPTION:** Analyzes, processes, and adjudicates all types of complex claims submitted in Centers for Medicare and Medicaid Services Form 1500 (CMS‑1500) and Uniform Billing Form 04 (UB‑04) formats, applying the highest level of analytical judgment to determine appropriate payment or denial. This includes the...

**About Lyra** Lyra Clinical Associates partners with Lyra Health, a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for the operation of the units that manage the Comprehensive Health Risk Assessment (CHRA), retrospective projects, and clinical coding processes. Guarantees compliance with established procedures following operational guidelines and rules established by the different accrediting agencies, such...

Date: Sep 10, 2026 Location: San Juan, PR Company: Popular Workplace Type: Hybrid **Business Analyst** Popular Is Committed To Developing And Providing Growth Opportunities For Our Employees. To Foster Our Commitment, We Continually Strive To Expand Our Internal Mobility Options. We Invite You To Take Look At The Following...

Regular Exempt **GENERAL DESCRIPTION:** Evaluates the handling, processing, and/or payment of medical and/or life insurance claims to seek efficiency in the claim adjudication processes of each of the analysts, according to the parameters established in the unit, and seeks continuous improvement and compliance with corporate results. Makes...

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 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,...

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...

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...

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...

Date: Sep 10, 2026 Location: San Juan, PR Company: Popular Workplace Type: Hybrid **Business Analyst / Specialized Businesses Group** Popular Is Committed To Developing And Providing Growth Opportunities For Our Employees. To Foster Our Commitment, We Continually Strive To Expand Our Internal Mobility Options. We Invite You To...

Date: Sep 10, 2026 Location: San Juan, PR Company: Popular Workplace Type: Hybrid **Industrial Engineer | Customer Journey** Popular Is Committed To Developing And Providing Growth Opportunities For Our Employees. To Foster Our Commitment, We Continually Strive To Expand Our Internal Mobility Options. We Invite You To Take Look...

**Scientific Games:** Scientific Games is the global leader in lottery games, sports betting and technology, and the partner of choice for government lotteries. From cutting-edge backend systems to exciting entertainment experiences and trailblazing retail and digital solutions, we elevate play every day. We push game designs to the next level and are...

**About Lyra** Lyra Clinical Associates partners with Lyra Health, a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published...

**Job description:** - **Job Type:** Manager - **Job Location:** San Juan - **Department:** Business Services | Compliance **Job Summary:** The Manager in the Business Services Department leads a team of professionals in delivering accurate and timely financial management services. This role oversees client engagements, ensures compliance with...