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especialista en desarrollo de la red

MCS HEALTHCARE HOLDINGS, LLC

<div>Especialista en Desarrollo de la Red 
Regular
Exempt 
GENERAL DESCRIPTION:
Evaluate and monitor the quality of service of the network to ensure that the service given by the providers is adequate. Maintains the Facility Provider Directory up to date and is responsible for preparing the corresponding communications. Guides and educates providers and department employees on manuals, laws, policies, procedures, and other topics that the company and regulatory agencies require.
ESSENTIAL FUNCTIONS:<ul><li>Discusses Performance Metrics reports with those providers as required by their contract.</li><li>Prepares, coordinates, and provides guidance to new and existing providers related to MCS products, billing, claims processing, complaints, and grievances related to claims payment, model of care, and related processes, among others.</li><li>Participates in meetings, activities, and training support to providers related to ICD-10, medical documentation, STARS, and Healthcare Effectiveness Data and Information Set (HEDIS), among others.</li><li>Identifies Center for Medicaid and Medicare Services (CMS) charters, laws, and regulations, and/or any other supporting text or references that were used to develop and serve as references in the document.</li><li>Facilitates, validates, and ensures that communications that are sent by delegated entities that mention or impact MCS meet the same standards and regulations as the letters that the company develops.</li><li>Ensures completion of Care Model distribution and updating of demographic data quarterly per CMS requirements.</li><li>Reports internal and external customer service quality surveys and evaluations.</li><li>Supports the generation of educational material according to the annual provider education plan.</li><li>Assist in the design and creation of educational materials and statements, according to regulations and CMS requirements.</li><li>Oversees and applies the provider&rsquo;s education work plan.</li><li>Support the STARS Program. Assist in the progress of the work plans and STARS improvement initiatives. Organize and interpret current performance, yearly trends, and predicted performance of assigned metrics within the context of STARS Program compliance.</li><li>Participates in strategic projects that will address the enhancement of the provider&rsquo;s experience and growth while promoting the improvement of access to care, service, and quality.</li><li>Establishes and complies with meeting schedules, both internal and external. Defines priorities and updates the schedule to ensure important or pending issues with providers are discussed and addressed within the established schedule.</li><li>Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.</li><li>May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.</li></ul>
MINIMUM QUALIFICATIONS:
Education and Experience: Bachelor&rsquo;s Degree in Business Administration, Health Services Administration, or related fields. At least two (2) years of experience managing healthcare provider interactions in customer service roles, including resolving inquiries and escalations, applying knowledge of healthcare insurance claims and grievance processes, and experience drafting professional documentation (letters, manuals, policies). Experience facilitating provider orientation, meetings, presentations, or training sessions is preferred.
&ldquo;Proven experience may be replaced by previously established requirements.&rdquo;
Certifications / Licenses: A Driver's License valid in the Commonwealth of Puerto Rico is required.
Other: Knowledge of medical billing. Basic knowledge of provider database systems. Familiarity with CMS regulations, provider communication standards, and compliance requirements related to provider education and network operations.
Languages: 
Spanish &ndash; Intermediate (comprehensive, writing and verbal) 
English &ndash; Intermediate (comprehensive, writing and verbal) 
&ldquo;We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.&rdquo;</div>

Especialista en Desarrollo de la Red

EPD Real Estate

Oficial de Recursos Humanos y N&oacute;mina, responsable de las funciones operacionales del Departamento de Recursos Humanos con &eacute;nfasis en la administraci&oacute;n de n&oacute;minas y el manejo de las relaciones laborales. Responsable de la implementaci&oacute;n de pol&iacute;ticas y garantizar el cumplimiento con las leyes laborales aplicables.Responsabilidades principales:<ul><li>Administrar&aacute; la n&oacute;mina de los empleados de forma precisa y puntual, lo cual incluye la revisi&oacute;n y/o preparaci&oacute;n de planillas trimestrales y anuales.</li><li>Responsable de la administraci&oacute;n de beneficios.</li><li>Mantendr&aacute; y actualizar&aacute; los expedientes de empleados y la documentaci&oacute;n de Recursos Humanos.</li><li>Brindar&aacute; apoyo en el manejo puntual de situaciones de relaciones laborales, incluyendo orientaci&oacute;n a los empleados, implementaci&oacute;n de acciones disciplinarias y seguimiento a situaciones internas.</li><li>Apoyar&aacute; en los procesos de reclutamiento, tales como: creaciones de descripciones de puesto, publicaciones de vacantes, coordinaci&oacute;n de entrevistas y seguimiento a candidatos. Realizar&aacute; entrevistas iniciales.</li><li>Preparar&aacute; documentos, cartas y comunicaciones relacionadas con Recursos Humanos.</li><li>Mantendr&aacute; confidencialidad en el manejo de informaci&oacute;n sensitiva de empleados.</li><li>Apoyar&aacute; en cualquier otra tarea relacionada, seg&uacute;n le sea requerido.</li></ul>Requisitos y habilidades<ul><li>Bachillerato en Recursos Humanos, Administraci&oacute;n de Empresas o &aacute;rea relacionada.</li><li>Biling&uuml;e.</li><li>Conocimiento en el programa de n&oacute;mina ADP.</li><li>Experiencia de 3-5 a&ntilde;os en el Campo de Recursos Humanos, preferiblemente en el manejo de N&oacute;mina.</li><li>Conocimiento intermedio a avanzando en leyes laborables.</li><li>Habilidad de manejo de informacion confidencial.</li><li>Excelentes habilidades de comunicaci&oacute;n verbal y escrita.</li><li>Dominio de Microsoft Office.</li></ul>Somos un Patrono con Igualdad de Oportunidad de Empleo &lt;EEO&gt;Tipo de puesto: Tiempo completoSueldo: $40,000.00 - $43,000.00 al a&ntilde;oBeneficios:<ul><li>Health insurance</li><li>Life insurance</li></ul>Lugar de trabajo: Empleo presencial

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West LLC

Encargado de instalar sistemas el&eacute;ctricos en nuestros proyectos, incluyendo paneles de distribuci&oacute;n, alimentadores, conductos, luminarias y equipos. Realizar troubleshooting y mantenimiento preventivo. Operar instrumentos y equipos de mediciones, para la reparaci&oacute;n y mantenimiento de los sistemas electromec&aacute;nicos.Requisitos<ul><li>Curso t&eacute;cnico de electricidad de una escuela vocacional o colegio t&eacute;cnico acreditado.</li><li>Dos a&ntilde;os o m&aacute;s de experiencia ejerciendo funciones de Ayudante de perito electricista.</li><li>Certificado de Ayudante de Perito Electricista vigente.</li></ul>Tipo de puesto: Tiempo completoSueldo: $14 la horaHoras previstas: 40 por semanaLugar de trabajo: San JuanPay: From $14.00 per hourWork Location: In person

Ayudante Electricista

Explore 3+ Especialista en desarrollo de la red in San Juan this April. Find roles across top companies and apply now to boost your career.

3 especialista en desarrollo de la red jobs In San Juan

Especialista en Desarrollo de la Red

Oficial de Recursos Humanos y Nómina

Ayudante Electricista