Utilization and Quality Specialist

Location: San Juan, PR, Puerto Rico
Date Posted: 06-11-2018
Available Position for Utilization and Quality Specialist within the Health Industry. Full Time.

Job Requirements:
* Work particularly with the clients who are mostly the Executive Directors of the Medical Groups.
* Must work the complete MS Suite (Word, Excel, PP) as it assists in everything that refers to the support of the Directors.
* Must know the insurance industry and the services that are regulatory to be able to evaluate areas of compliance with the Health Reform program.
* Must understand the concepts of rigor around the use of plan utilization and billing.
* Serve as an integrating entity because it would be taking control of what is happening in the client's facilities and the administration of the plans.
* Participate in monthly meetings with executives in order to capture information relevant to the reports that must be submitted.
* Requires its own car and would be making visits to clients throughout the Island.


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