Healthcare Operations Team Lead

MCS Health; San Juan (PR); On-site; USD 36,000 - 60,000; Full time

Job summary

MCS Health in Puerto Rico seeks an operations specialist to support daily unit operations, overseeing document intake, evaluation, and distribution while guiding technicians and coordinating with internal and external teams.

Responsibilities include ensuring accurate document management, monitoring intake channels, and maintaining compliance with CMS and related regulations. Strong focus on training, quality, and PHI confidentiality.

Qualifications

• Associate’s Degree or 60 approved college credits in Health Administration, Business Administration, or a related field.
• At least two (2) years of experience in healthcare operations, preferably in Grievances & Appeals, document intake, or receipt and distribution processes.
• Proven experience may be replaced by previously established requirements.

Responsibilities

• Supports daily unit operations by completing document intake, evaluation, classification, and distribution.
• Provides guidance to technicians, resolving complex issues and serving as liaison between operational areas, internal teams, and external stakeholders.
• Oversees document management processes, acting as gatekeeper to ensure accurate receipt, classification, prioritization, and routing of requests, while identifying duplicates and inconsistencies.
• Monitors intake channels (fax, email, CRM) and workload to ensure timely processing, early identification of backlogs, and compliance with regulatory requirements.
• Ensures equitable distribution of work among technicians based on established quotas and priorities.
• Tracks case aging and service timelines to ensure compliance with CMS, OIC, and applicable regulations, including Medicare Stars measures.
• Promotes training and mentorship to new and existing employees, reporting progress to management.
• Maintains control and confidentiality of PHI and unit documentation in accordance with policy.

Skills

Spanish (Basic)

English (Intermediate)

Education

Associate degree or 60 credits in Health Admin/related

Job description

MCS Health in Puerto Rico seeks an operations specialist to support daily unit operations, overseeing document intake, evaluation, and distribution while guiding technicians and coordinating with internal and external teams.

Responsibilities include ensuring accurate document management, monitoring intake channels, and maintaining compliance with CMS and related regulations. Strong focus on training, quality, and PHI confidentiality.