At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
This position leads critical internal processes that enable GuideWell-Triple-S's effective engagement, participation, and influence in the BCBS Association's (BCBSA) governance process as a means of influencing the Blue System agenda and policy in ways that support the achievement of GuideWell and Triple-S business strategies. Accountable for leadership over Triple-S's Inter-Plan Compliance Program and Inter-Plan Executive Inquiry-Escalation Program; Leads processes for ensuring CEO and senior leader preparation for participation and influence on respective BCBS Boards-Committees and related Blue organizations.
ESSENTIAL FUNCTIONS
Governance and Strategy:
Prepare executive briefings on BCBSA and CHP policies, proposals, and governance actions.
Analyze and interpret complex information to assess impact on Puerto Rico operations, including regulatory, financial, and operational considerations.
Support development of Triple-S positions on BCBSA-CHP matters, ensuring alignment with local strategy and enterprise priorities.
Develop executive-level materials such as presentations, reports, decision memos, and scorecards.
Coordinate and support participation of Triple-S leaders in BCBSA and CHP committees and workgroups.
Track engagement and ensure alignment between enterprise governance and Puerto Rico operations.
Independently or collaboratively researches, analyzes, maintains, modifies, validates, prepares, and interprets complex data, information and content necessary to support Plan positioning and business decision-making on BCBSA and CHP governance proposals-key issues; Presents findings and articulates results to all levels of leadership.
Compliance and Regulatory Alignment:
Support compliance with BCBSA mandates and national programs, ensuring applicability to Puerto Rico regulations and market dynamics.
Coordinate required certifications, reporting, and documentation with local leadership.
Assist with internal audits, corrective action plans, and policy exception tracking.
Serve as a subject matter resource on BCBSA policies and their application within Puerto Rico.
Partner with compliance, legal, and operational teams to ensure adherence to local and federal healthcare regulations.
Stakeholder Engagement and Liaison:
Act as liaison between Triple-S and BCBSA-CHP stakeholders, as well as enterprise partners.
Build and maintain effective relationships with internal departments (clinical, operations, finance, compliance) and external partners.
Support executive-level requests related to BCBSA, including analysis, reporting, and presentations.
Represent Triple-S in governance meetings, audits, and external forums as needed.
Process Improvement and Execution:
Identify and implement opportunities to improve governance and compliance processes within Triple-S.
Monitor effectiveness of policies and workflows; recommend enhancements to drive efficiency and compliance.
Support resolution of escalated BCBSA or inter-plan issues impacting Puerto Rico operations.
Manage multiple priorities independently and deliver high-quality, timely results.
EDUCATION
- Bachelor's Degree in Business Administration
- Master's Degree in Business Administration
EXPERIENCE
Bachelor degree in Business Administration with six or more years of related work experience. Master degree prefered.
LICENSES AND CERTIFICATIONS
- None required
COMPETENCIES
- Action Oriented
- Collaborates
- Customer Delight
- Instills Trust
- Manages Ambiguity
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.