En Triple-S, estamos comprometidos con brindar experiencias laborales significativas para nuestra Gente Valiosa. Nos esforzamos por la excelencia en todo lo que hacemos, desde la forma en que trabajamos juntos hasta la forma en que servimos a nuestros clientes.
Al unirte a Triple-S, serás pieza clave para nuestros esfuerzos de brindar atención médica accesible y de alta calidad, así como también contribuirás a nuestro propósito de habilitar vidas saludables. Servimos a más de a más de 1 millón de asegurados en Puerto Rico, a través de nuestras líneas de negocios Medicare Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia.
Construyamos comunidades saludables juntos. ¡Únete a nosotros!
JOB SUMMARY
The Network Operations Coordinator plays a critical role in ensuring the efficient execution and continuous improvement of operational processes. This position is responsible for managing the intake and triage of operational requests, conducting initial general assessments, and coordinating the appropriate assignment or escalation to relevant teams or stakeholders. The role requires strong organizational, documentation, and communication skills to maintain visibility across workflows, drive timely resolution of tasks, and support operational excellence. Additionally, the Operations Coordinator oversees tracking mechanisms, maintains dashboards and documentation, monitors key performance metrics, and contributes to audit readiness and reporting deliverables. This role serves as a central point of coordination, ensuring alignment, accountability, and consistency across operational activities.
ESSENTIAL FUNCTIONS
- Manage the end-to-end intake process for operational requests, ensuring accurate documentation, prioritization, and timely acknowledgment.
- Perform initial evaluation and triage of incoming requests to determine scope, urgency, and required actions.
- Assign tasks to appropriate teams or stakeholders based on predefined criteria, or escalate issues as needed to ensure prompt resolution.
- Maintain and continuously update dashboards, trackers, and documentation to provide real-time visibility into request status, progress, and outcomes.
- Ensure proper follow-up and closure of all assigned items, validating that deliverables meet established standards and requirements.
- Assist in audit preparation activities, including evidence gathering, documentation review, and coordination of audit-related deliverables.
- Identifies and conducts assessments of requirements based on local and external regulations, contract changes and business needs.
- Ensures URAC-NCQA accreditation standards are incorporated and maintained.
- Support the development and maintenance of standard operating procedures (SOPs), process documentation, and division policies.
- Collaborates and provides guidance in the design of efficient and compliant metrics. Performs operational monitoring of processes and key performance metrics.
Conducts compliance surveillance for the division to ensure that regulatory requirements are followed. - Monitors compliance metrics and recommends appropriate actions.
- Collaborate cross-functionally to ensure alignment, resolve dependencies, and improve process efficiency.
- Assists in the process improvement analysis and redesign for procedures and working practices.
- Coordinates activities-projects of low to medium level of complexity. Develops, monitors and reports work plans and activities in the critical path for projects-tasks assigned.
- Coordinate meetings, track action items, and ensure follow-through on operational commitments.
Conducts training and development activities for the division especially but not limited to regulations. - Provide general administrative and operational support as needed to ensure smooth day-to-day operations.
EDUCATION
- Bachelor's Degree in Administracion de Empresas or Administracion de Servicios de Salud
Bachelor’s degree, preferably in Business Administration, Health Service Administration or in related areas, with one (1) to three (3) years of experience in project coordination, business analysis, network administration, healthcare compliance, or related fields.
LICENSES AND CERTIFICATIONS
- No requerido
COMPETENCIES
- Orientado a la Acción
- Colaboración
- Deleite al Cliente
- Inspira confianza
- Maneja la Ambigüedad
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