Clinical Operations Compliance & Analytics Analyst

MCS Health; San Juan (PR); On-site; USD 70,000 - 95,000; Full time

Job summary

MCS Healthcare Holdings, LLC (MCS) seeks a Clinical Operations Monitoring Analyst to oversee operational and regulatory processes, ensuring compliance with federal, state, and contractual requirements. You will analyze KPIs, trends, and data to identify risks and areas for improvement, delivering timely, accurate reporting to support leadership decisions.

In this role, you’ll develop and standardize reports, dashboards, and CAPs, collaborate across functions, and participate in audits and

Qualifications

• Bachelor's degree in Business Administration, Health Services Administration, or related fields.
• Minimum of three (3) years of experience supporting Medicare Advantage and Medicaid in health care operations.
• Proficiency in Excel, reporting tools, and operational software is preferred.
• Languages: Spanish – Advanced and English – Intermediate.

Responsibilities

• Monitor operational and regulatory processes for compliance with federal, state, contractual, and organizational requirements.
• Analyze KPIs and operational data to identify opportunities for improvement and mitigate risks.
• Develop, maintain, validate, and standardize reports, dashboards, scorecards, and leadership presentations.
• Support corrective action plans (CAPs) and perform root cause analyses to drive improvements.
• Conduct audits and process reviews to ensure accurate categorization, documentation, and timely resolution.
• Identify and elevate operational, compliance, and quality concerns to management for action.
• Monitor workload inventories, aging reports, turnaround times, and service levels for compliance.
• Collaborate with cross-functional teams to implement process improvements.
• Participate in regulatory audits, readiness activities, and data validation as required.
• Maintain documentation and records per policies and procedures.

Skills

Excel

Reporting tools

Operational software

Spanish

English

Education

Bachelor's degree in Business Administration / Health Services Administration

Job description

MCS Healthcare Holdings, LLC (MCS) seeks a Clinical Operations Monitoring Analyst to oversee operational and regulatory processes, ensuring compliance with federal, state, and contractual requirements. You will analyze KPIs, trends, and data to identify risks and areas for improvement, delivering timely, accurate reporting to support leadership decisions.

In this role, you’ll develop and standardize reports, dashboards, and CAPs, collaborate across functions, and participate in audits and