Beneficiary Value Program Efficiency Analyst

MCS Puerto Rico; San Juan (PR); On-site; USD 42,000 - 60,000; Full time

Job summary

MCS Puerto Rico is seeking an Efficiency Analyst for the Beneficiary Value Program to analyze operational data, develop reports, and support Te Paga initiatives. This role provides administrative and analytical support in regulatory compliance and continuous improvement efforts.

You will work with the program team to follow plans, document findings, validate vendor reports, and resolve discrepancies while upholding company policies and applicable laws.

Qualifications

• Bachelor's degree in Business Administration or related areas.
• 60-64 approved university credits or an Associate Degree in Business Administration or related areas.
• Three or more years of relevant process analysis, audit or controls experience preferred.
• "Proven experience may be replaced by previously established requirements."
• Availability to work on weekends, holidays, and extended hours as needed.

Responsibilities

• Analyzes and interprets data to provide recommendations for change based on judgment and experience.
• Processes and classifies data according to established policies and documents modifications.
• Assists in implementing initiatives, ensuring regulatory compliance and goals achievement.
• Follows a detailed work plan for each initiative, documenting findings and results.
• Collaborates with team to identify gaps, barriers and opportunities for improvements.
• Follows up on assigned items and notifies supervisor of findings.
• Validates vendor error reports and processes corrections as applicable.
• Investigates and resolves discrepancies in transactions reported by internal or external teams.
• Complies with all company policies, procedures, and applicable laws and regulations.

Education

Bachelor's degree in Business Administration or related areas

60-64 approved university credits / Associate Degree in Business Administration or related areas

Job description

Regular

Non-Exempt

GENERAL DESCRIPTION

The Beneficiary Value Program Efficiency Analyst is responsible for preserving the quality of the product by analyzing and developing operational data and report requests related to Te Paga. Provides administrative and analytical support in the implementation and monitoring of Te Paga-related initiatives, derived from regulatory requirements, new industry trends, and the company's strategic plans. Supports the execution, validation, and continuous improvement of Te Paga operational processes and reports to the direct supervisor on the results of initiatives, implementations, and process performance.

ESSENTIAL FUNCTIONS

• Analyzes and interprets data to provide recommendations for change based on judgment and experience, applies product policies and assesses risks to minimize exposure and mitigate risks.
• Processes and classifies data according to the established policies and documents any modifications in the internal records.
• Assists in the implementation of initiatives related to the unit, ensuring compliance with regulatory agencies, and facilitating the attainment of corporate and departmental goals and objectives.
• Follows a detailed work plan for each initiative, documenting the corresponding findings and results of each initiative or referral.
• Collaborates with Program's team members to identify projects gaps, barriers and opportunities for improvements.
• Follows up on assigned items and promptly notifies the direct supervisor of any findings.
• Validates vendor's error reports generated and process any applicable correction.
• Investigates and resolves discrepancies in transactions reported by internal or external teams.
• 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.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

Minimum Qualifications

Education and Experience: Bachelor's degree preferably in Business Administration or related areas. At least one (1) year of experience in process analysis, audit or controls-related positions preferably within the health insurance industry and Medicare Advantage or in the banking industry managing debit cards.

OR

Education and Experience: At least sixty to sixty-four (60-64) approved university credits equivalent to two (2) years of studies or an Associate Degree in Business Administration or related areas. At least three (3) years of experience in process analysis, audit or controls-related positions preferably within the Health Insurance Industry and Medicare Advantage or in the banking industry managing debit cards.

\"Proven experience may be replaced by previously established requirements.\"

Certifications / Licenses: N/A Other: Availability to work on weekends, holidays, and extended hours as needed based on operational requirements.

Languages

Spanish – Intermediate (comprehensive, writing and verbal)

English – Intermediate (comprehensive, writing and verbal)

\"We are an Equal Employment Opportunity Employer and take affirmative action to recruit Protected Veterans and Individuals with Disabilities.\"