InnovaCare San Juan Puerto Rico
2 months ago
LE0002 MMM Holdings, LLC
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Evaluate information gathered from users, reconcile data, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish customer/user requests from true incidents
- Participate in cross functional task forces to identify and document issues and situations.
- Production monitoring, triage, code investigations and data updates for all applications
- Performing initial triage of production incidents to identify code or data issues
- Creating and testing database scripts to correct data anomalies
- Interfacing with Application Developers to communicate issues and suggest remediation
- Engage appropriate internal resources to resolve technical issues and deliver updated status reports to our customers on... progress toward resolutions
- Ensure that each support issue and resolution is adequately documented
- Assist in the QA process of new iterations of the product by developing and executing User Acceptance Test plans
- Determine which issues require product development support and redirect those that do not to the appropriate resolution team
EDUCATION AND EXPERIENCE
- Bachelors Degree in Computer Science, Bachelor Degree in Information System Engineering, Master degree in Computer science or Bachelor Degree in Business Administration/Health Administration and +5 years of business analysis experience or information technology area and at least 3 year in the health care services area a plus.
- Extensive knowledge of MS Office Suite, MS Visio, MS Project,
- Knowledge of MS Technologies.
- Experience working and implementing SDLC and Agile Methodologies.
- Experience in Health care payer systems, Clinical Applications, Electronic Medical Records, and Provider's Billing Applications a plus.
- Experience in the areas of application programming, database and system design. Understands Internet, Intranet, Extranet and multi tear architectures and how legacy and web-based systems interface with each other.
GENERAL KNOWLEDGE AND ABILITIES
- Requires excellent communication skills, and provides a positive team player attitude with the ability to interface with all varied levels of employment.
- Ability to conduct product demonstrations and support product implementations.
- Analytical skills, to critically evaluate the information gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a more general understanding, distinguish presented user requests from the underlying true needs, and distinguish solution ideas from requirements.
- Facilitation skills, to lead requirements elicitation workshops.
- Observational skills, to validate data obtained via other techniques and expose new areas for elicitation.
- Must have excellent writing skills, to communicate information effectively to customers, marketing, managers, and technical staff.
- Organizational skills, to work with the vast array of information gathered during elicitation and analysis and to cope with rapidly changing information.
- Interpersonal skills, to help negotiate priorities and to resolve conflicts among project stakeholders (such as customers, product management, and engineering).
- Modeling skills, to represent requirements information in graphical forms that augment textual representations in natural language, including using modeling languages already established in the development organization.
- Must be able to work independently with limited supervision.
- Flexible and carrier of a positive attitude.
- Self-starter and problem solver.
Fully Bilingual. Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to effectively present information to management and/or public groups,.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
- Proactive and Leadership
- Generates enthusiasm among team members
- Proactively seeks opportunities to serve in leadership roles
- Challenges others to develop as leaders while serving as a role model
- Facilitates effective team interaction
- Acknowledges and appreciates each team member's contributions
- Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
- Communicates effectively with users to identify needs and evaluate alternative business solutions with project management
- Continually seeks opportunities to increase customer satisfaction and deepen end-user relationships
- Manages end-users expectations effectively
- Analytical & Systems Thinking
- Ability to deliver informative and well-organized presentations
- Ability to communicate difficult/sensitive information tactfully
The responsibilities of this position require continuous interaction with colleagues.
Managers Supervisors Internal MMM departments
Beneficiaries Providers Vendors
PHYSICAL AND MENTAL DEMANDS
The position requires sitting, standing and walking associated with a normal office environment, talking and hearing. This position requires weight to be lifted or force to be exerted up to 10 pound.
ENVIRONMENTAL AND WORKING CONDITIONS
While working the employee is exposed to a general normal office environment. Employee may work occasional evening or weekend work. The noise in the work environment is moderate.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
Innovacare, Inc. is the leading provider of healthcare management in North America. Through two it's main ways, Medicare Advantage and the provider network, we are committed to healthcare, creating models that are sustainable, cost-effective, and fully integrated with the most advanced technologies. Innovacare, Inc. combines innovation and quality care to create progressive, value-based models, even for the neediest patient populations. Our leadership team, with its vast years of combined experience in managed care and care delivery, is made up of leading experts with proven experience to help healthcare organizations effectively meet and exceed the growing demands of our industry.
InnovaCare Health's foundation was laid by President and CEO Richard Shinto, M.D., in 1998, when he joined North American Medical Management (NAMM) in California. Over the next 10 years, the company continued to grow, acquiring MMM Healthcare in Puerto Rico. In December 2012, the management team successfully sold select NAMM properties and officially formed InnovaCare Health to operate the remaining subsidiaries, including MMM. MMM Holdings, is a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries, through Medicare y Mucho Más (MMM), and for the beneficiaries of the government health plan with MMM Multihealth. Through InHealth Management, it manages the in-hospital care of the beneficiaries, while the specialized clinics, MMM Vita Care, serve members with chronic conditions. On the other hand, MSO of Puerto Rico supports medical groups, providers and other entities in the health industry, while Castellana Physicians Services is a medical group dedicated exclusively to providing services for the elderly and disabled population in Puerto Rico.
At the same time, the main company manages Medicare and Much More, a Medicare Advantage population health plan with a presence in Miami-Dade, Broward and Palm Beach counties. With a Mobile Application that allows members to check the status of their pre-authorizations, access their provider directory and schedule their future medical visits, Medicare and Much More integrates technology as a tool to improve the member experience. Also, the plan will ensure the health of members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to their covered Part D drugs.
Orlando Family Physicians, a group of clinics that provide comprehensive care services in the state of Florida, is another of the companies managed by Innovacare, Inc. With more than 20 years of service in the Central Florida community and more than 100,000 patients cared, Orlando Family Physicians offers the personalized treatment and care that the patient deserves. With a track record that proves excellent customer service, we are proud that the largest Hispanic medical group in Central Florida has joined us. Our constant growth is the best witness we have to tell that things are being done well, so it is our commitment to continue on this path.
Innovacare, Inc. es el proveedor líder de manejo de servicios de salud en Norteamérica. A través de dos principales vías, Medicare Advantage y la red de proveedores, estamos comprometidos al cuidado de la salud, creando modelos que son sostenibles, costo-efectivos y completamente integrado a las tecnologías más avanzadas. Innovacare, Inc. combina innovación y atención de calidad para crear modelos progresivos y basados en el valor, incluso para las poblaciones de pacientes de mayor necesidad. Nuestro equipo de liderazgo con sus vastos años de experiencia combinada, en atención administrada y prestación de atención, está formado por expertos preeminentes con la experiencia comprobada para ayudar a las organizaciones de atención médica a satisfacer y superar eficazmente las crecientes demandas de nuestra industria.
Las bases de InnovaCare Health fueron establecidas por el presidente y CEO Richard Shinto, M.D., en 1998, cuando se unió a North American Medical Management (NAMM) en California. Durante los próximos 10 años, la compañía continuó creciendo, adquiriendo MMM Healthcare en Puerto Rico. En diciembre de 2012, el equipo de gestión vendió con éxito propiedades selectas de NAMM y formó oficialmente InnovaCare Health para operar las filiales restantes, incluida MMM.
MMM Holdings, es un conglomerado de compañías que trabaja las estrategias de negocio de Puerto Rico, tanto para Medicare Advantage, a través de Medicare y Mucho Más (MMM), como para los beneficiarios del plan de salud del Gobierno con MMM Multihealth. A través de InHealth Management maneja el cuidado intrahospitalario de los beneficiarios, mientras que, las clínicas especializadas, MMM Vita Care, atienden afiliados con condiciones crónicas. Por otro lado, MSO of Puerto Rico apoya grupos médicos, proveedores y otras entidades en la industria de la salud, mientras Castellana Physicians Services es un grupo médico dedicado exclusivamente a proveer servicios para la población de edad avanzada y discapacitada en Puerto Rico.
A su vez, la compañía matriz maneja Medicare and Much More, plan de salud para la población Medicare Advantage con presencia en los condados de Miami-Dade, Broward y Palm Beach. Con una Aplicación Móvil que permite a los afiliados verificar estatus de sus pre-autorizaciones, acceder su directorio de proveedores y agendar sus futuras visitas médicas, Medicare and Much More integra la tecnología como una herramienta para mejorar la experiencia del afiliado. También, el plan velará por la salud de los afiliados durante y después de desastres naturales. Por eso, a través de la línea de cuidado MMM de Florida, como patrocinador de la Parte D, se asegurará de que el afiliado tenga acceso adecuado a sus medicamentos cubiertos de la Parte D.
Orlando Family Physicians, grupo de clínicas que brindan servicios para el cuidado integral en el estado de la Florida, es otra de las compañías manejadas por Innovacare, Inc. Con más de 20 años de servicio en la comunidad de Florida Central y más de 100.000 pacientes atendidos, Orlando Family Physicians ofrece el tratamiento personalizado y la atención que el paciente merece. Con una trayectoria que prueba un excelente servicio al cliente, estamos orgullosos de que el grupo médico hispano más grande en Florida Central se haya unido a nosotros. Nuestro constante crecimiento es el mejor testigo de que las cosas se están haciendo bien por lo que es nuestro compromiso continuar por ese camino
San Juan Puerto Rico
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