Clinical Operations & Integration Architect

Triple-S; Guaynabo (PR); On-site; USD 90,000 - 130,000; Full time

Job summary

Triple-S is seeking a senior leader to translate executive Clinical Operations goals into actionable roadmaps, scalable staffing, and integrated workflows across Utilization Management, Case Management, and Population Health. The role requires leading cross-functional teams, managing vendor relationships, and driving performance to deliver high-quality, cost-efficient care.

A bachelor’s degree in a health-related field and 3+ years in managed care are required, with PMP/Lean Six Sigma/CPHQ

Qualifications

• Bachelor’s degree in health care administration, business administration, Public Health, Nursing or related field.
• Minimum of 3 years in progressively responsible in managed care and/or insurance environment.
• PMP, Lean Six Sigma Green/Black Belt or CPHQ certification preferred.

Responsibilities

• Translate high-level VP vision into a concrete, multi-quarter execution roadmap and prioritize initiatives.
• Design and oversee departmental resource allocation, staffing models, and operational frameworks.
• Identify cross-functional dependencies, bottlenecks, and risks; design mitigation strategies to keep projects on time and budget.
• Monitor processes to drive operational excellence and lead innovation to improve clinical outcomes and reduce cost of care.
• Manage high-level relationships with external clinical leadership and key vendors, ensuring SLA compliance and strategic alignment.
• Drive cross-functional synergy by integrating UM, CM, and Population Health under standardized, data-driven collaboration.

Skills

Leadership

Strategic Planning

Stakeholder Management

Cross-functional Collaboration

Operational Excellence

Education

Bachelor's Degree in Business Administration or Public Health

PMP / Lean Six Sigma / CPHQ (preferred)

Job description

Triple-S is seeking a senior leader to translate executive Clinical Operations goals into actionable roadmaps, scalable staffing, and integrated workflows across Utilization Management, Case Management, and Population Health. The role requires leading cross-functional teams, managing vendor relationships, and driving performance to deliver high-quality, cost-efficient care.

A bachelor’s degree in a health-related field and 3+ years in managed care are required, with PMP/Lean Six Sigma/CPHQ