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
Responsible for coordinating provider engagement and health education initiatives that promote compliance with Government Program contractual requirements, quality improvement strategies, and organizational goals. Serves as the primary liaison between the Provider Engagement Department and network providers by coordinating educational activities, monitoring compliance initiatives, supporting provider onboarding, implementing engagement strategies, and assisting providers in closing quality and operational gaps. Develops and delivers educational presentations, training sessions, workshops and seminars to providers, staff offices, internal teams and other audiences as required.
ESSENTIAL FUNCTIONS
- Coordinate provider engagement initiatives aligned with departmental and corporate strategic goals.
- Assist in provider onboarding and orientation processes and identify opportunities for provider education and engagement
- Support the execution of provider engagement plans and outreach activities.
- Build and maintain collaborative relationships with physician offices, medical directors, practice administrators and provider staff.
- Develop, distribute and oversee the annual provider guidelines and education calendar to ensure timely delivery of educational initiative and compliance with organizational objectives.
- Develop educational materials related to Government Programs requirements and submit the provider guidelines for review and approval in accordance with contractual requirements.
- Manage the inventory of provider educational materials, communication resources, and training documentation to ensure content is current and compliant.
- Support the planning, coordination, and logistics of Provider Advisory Board, physician forums, and meetings with medical groups. Prepare meeting agendas, minutes and follow-up activities
- Serve as the primary liaison between the Quality, Compliance, and Provider Engagement teams and network providers regarding regulatory requirements, quality initiatives, and compliance-related matters.
- Ensure educational communications meet regulatory and health literacy standards.
- Coordinate and facilitate provider educational sessions, webinars, workshops and provider training events.
- Collaborate and coordinate provider training with MOCs, PBM, MBHO and academic institutions.
- Develop, monitor and report Key Performance Indicators (KPIs) related to provider education, engagement, participation, and program effectiveness.
- Monitor provider compliance with Government Program contractual requirements and completion of required provider attestations and mandatory training.
- Prepare, analyze and distribute monthly reports in accordance with departmental and contractual requirements.
- Maintain accurate documentation of provider interactions (training and technical assistance activities)
EDUCATION
- Bachelor's Degree in Health Education or Public Administration
EXPERIENCE
- Bachelor’s Degree (BD) in Health Education, Public Health, Health Administration or Related Healthcare Field (1) to three (3) years of experience.
- Current/valid professional license without restrictions, if applies.
LICENSES AND CERTIFICATIONS
COMPETENCIES
- Action Oriented
- Collaborates
- Customer Delight (Employee)
- 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.