• Puerto Rico

Develop and manage specialty programs, track progress, optimize and manage specialty claims auditing process, drive generation of client-facing tools, develop healthcare analyses, ensure regulatory standards are met. Pharmacy degree and 8+ years of...

• US National

Process configuration plan setup and maintenance for new and existing clients. Organize and distribute work for team members. Develop team, lead training, and mentorship. Collaborate with peers and guide projects.

• San Juan, VA, Puerto Rico

Drive improvements to current business processes, optimize performance, meet best practices, improve quality, and enhance client experience. Manage multiple projects, analyze data, collaborate with teams, and provide progress reports.

• San Juan, Puerto Rico

Manage multiple medium-sized or highly complex projects from conception to completion, ensuring scope, time, and budget adherence. Coordinate project work efforts, document status, and provide progress reports to management. Develop and implement man..

• US National

Manage multiple medium-sized or highly complex projects from conception to completion, adhering to Project Management and Process Improvement methodology. Coordinate communication with stakeholders, provide progress reports, and optimize business per..

• San Juan, Puerto Rico

Lead HRIS system enhancements and upgrades. Oversee platforms and databases in Talent Strategy team. Collaborate with leaders and departments to configure and customize HR software to meet organization's needs.

• San Juan, Puerto Rico

Shape and manage employee services, benefits, payroll, policy development, compensation strategy, wellness, and labor relations. Foster a robust workforce culture and brand by building strong relationships with leaders and employees.

• US National

Lead a team of Rx Customer Service Specialists, overseeing scheduling, training, and quality monitoring. Manage incoming calls and ensure compliance with service-level standards. Mentoring and development of team. Bilingual fluency in Spanish and Eng...

• San Juan, Puerto Rico

Manage incoming calls, emails, and faxes from pharmacies, beneficiaries, and prescribers. Provide customer service and support, including rejection support and coverage determination status. Report issues to appropriate departments for investigation ..

• US National

Manage client benefit requirements, consult, maintain client relationships, collaborate with teams, educate stakeholders. Bachelor's/Master's degree and 6+ years healthcare/pharmacy experience required. Bilingual fluency in Spanish/English preferred.

• San Juan, Puerto Rico, or US National

Participate in analysis, design, development, and maintenance of critical business processes. Automate data exchange between company and external partners. Collaborate with peers to support delivery of new applications or processes.

• San Juan, Puerto Rico

Develop and initiate software applications and tools. Write, translate, and code software programs, applications, scripts, testing frameworks and tools. Collaborate with peers across the organization to support the delivery of new applications or pro..

• Puerto Rico

Negotiate rebate agreements and manage relationships with pharmaceutical manufacturers. Analyze data to identify savings opportunities for clients. Serve as rebate SME and provide support during regulatory change management process.

• US National

Debug and propose solutions for software issues, assist customers with platform functionalities, troubleshoot technical problems, collaborate with development teams, maintain documentation, provide support, and stay updated on issues and processes.

• US National

Monitor and analyze timely and accurate execution of Government Programs Encounter data processes while adhering to compliance requirements and service level agreements. Ensure the resolution of any errors affecting Encounter processes in a timely ma..

• San Juan, Puerto Rico

Analyze rebate invoices, generate reconciliations, and design tools for accurate and complete data related to rebates billing. Support data management and develop policies for rebates data flow. Collaborate with stakeholders and address data quality ..

• Puerto Rico

Analyze rebates invoices, generate reconciliations, design tools to ensure data accuracy. Collaborate with stakeholders to identify needs for improved data solutions and automate tasks. Provide analytical support for rebates process management.

• San Juan, Puerto Rico, or US National

Facilitate formulary design reviews with clients, manage formulary test claims, ensure compliance with regulations, assist in formulary audits, coordinate documentation, provide client support, and contribute to system improvements.

• US National

Support modernization and optimization of Security policies and procedures. Assist in developing and enhancing security GRC processes. Participate in vulnerability assessments and HITRUST certifications to support security and compliance maturity.

• San Juan,, Puerto Rico

Ensure successful completion of assigned audit engagements with delegated entities. Manage and carry out operational audit activities. Apply audit and monitoring techniques to identify deficiencies and best practices in controls and compliance.

• US National

Perform testing and monitoring activities, develop and execute test plans, analyze and report on test results, and track issues identified during testing. Lead development of new ideas and requirements to improve systems and guide other QA Analysts.

• US National

Monitor, analyze, and report on service level agreements. Analyze data to identify trends and areas for improvement. Generate regular reports on service performance and collaborate on service improvement initiatives.

• US National

Optimize testing and monitoring activities for systems and processes. Develop and execute test plans, analyze and report on test results, and track issues identified during testing. Collaborate with teams to improve testing strategies and tools.

• US National

Manage operational calls, agenda development, key client meetings and requests. Follow up pending topics and reach out to other business areas to provide resolutions. Maintain a central log of all issues, questions, discussions, and responses.

• US National

Analyze and report on data lakes, files, and tasks. Create and analyze reports, develop recommendations for modifications, and ensure data integrity and accuracy. Collaborate with other departments and provide guidance on reporting and data collection.

• US National

Identify, analyze, document, and report issues that may impact clients or members. Collaborate with other departments, conduct investigations, and make recommendations for corrective action and process improvements.

• US National

Monitor performance trends, detect anomalies, develop recommendations, and provide consolidated reporting on key metrics. Lead functional review of performance metrics for business areas and program management to drive scalability and efficiency.

• San Juan, PR, Puerto Rico

Analyze healthcare claims data for trend performance and operational opportunities. Perform root-cause analysis and communicate results to clients. Collaborate with stakeholders and develop data collection processes and analytics solutions.

• San Juan, PR, Puerto Rico

Translate business requirements into reporting deliverables, develop and improve report formats, analyze healthcare claims data, collaborate with stakeholders, and provide support to internal departments.

• US National

Analyze healthcare claims data to identify trends and opportunities, perform root-cause analysis, communicate results to clients, develop reports and dashboards, and ensure data accuracy. Bachelor's degree and 3+ years of experience required.