Network Management Coordinator

MCS Puerto Rico; San Juan (PR); On-site; USD 36,000 - 48,000; Full time

Job summary

MCS Puerto Rico is seeking an Administrative Coordinator to support department operations, manage documentation, and ensure regulatory alignment. You will coordinate provider-related requests, maintain records, and assist in audits and reporting with various internal systems.

The role emphasizes cross-team communication, process efficiency, and adherence to local and federal requirements within the healthcare insurance space. Strong organizational skills are essential.

Qualifications

• Bachelor's degree in Secretarial Science, Office Systems, or Business Administration.
• At least six months of experience performing provider services, network administration, and/or coordination in Healthcare Insurance preferred.
• Associate degree with 1 year of experience in provider services, network administration, and/or coordination in Healthcare Insurance preferred.
• High School Diploma with 2 years of experience in provider services, network administration, and/or coordination in Healthcare Insurance preferred.
• Proven experience may be replaced by previously established requirements.
• Certifications/licenses not required.

Responsibilities

• Receives, documents, and routes operational requests related to the network administration from various internal and external channels.
• Monitors and follows up on requests using internal systems to ensure timely responses and regulatory compliance.
• Manages communications with providers and internal teams; routes inquiries and reports potential risks.
• Prepares logs and administrative documents in compliance with policies and regulations.
• Coordinates meetings, minutes, agendas, and operational activities with providers and teams.
• Maintains physical and digital records for audits and inquiries; supports process efficiency.

Skills

Administrative support

Documentation management

Regulatory compliance

CRM / CRM systems

Provider services coordination

Communication skills

Education

Bachelor's Degree in Secretarial Science/Office Systems/Business Administration

Associate's Degree or 60-64 college credits

High School Diploma or technical training

Tools

CRM systems

SAI 360

Credentialing Digital Platform

Job description

Responsible for coordinating, routing, and following up on operational requests related to the department and/or unit. Provides administrative support, manages documentation, and ensures compliance with internal processes and regulatory requirements, contributing to operational efficiency and service quality.

Regular
Non-Exempt

GENERAL DESCRIPTION

Responsible for coordinating, routing, and following up on operational requests related to the department and/or unit. Provides administrative support, manages documentation, and ensures compliance with internal processes and regulatory requirements, contributing to operational efficiency and service quality.

ESSENTIAL FUNCTIONS

• Receives, documents, and routes operational requests related to the network administration from various internal and external channels.
• Monitors and follows up on requests using internal systems and electronic platforms to ensure timely responses, traceability, and compliance with regulatory requirements.
• Manages communications (phone, email, fax, regular mail, or in-person) with providers and internal teams, routing inquiries and reporting potential risks.
• Prepares logs and files administrative documents such as letters of agreement, reports, credentialing files review, provider’s exclusion lists, letters to providers, letters to impacted membership, and contracts in compliance with applicable internal and external policies and regulations, as applicable.
• Coordinates meetings, minutes, agendas, and operational activities with providers, external resources, and or internal teams based on business needs.
• Organizes, maintains, or provides physical and digital records to ensure availability for audits, inspections, or internal inquiries upon request
• Collaborates with other administrative areas and delegated entities to ensure consistency and efficiency in processes supporting the network administration.
• Consolidates and reports operational information to support decision-making, including status updates, operational metrics, and compliance alerts.
• Performs basic validations in internal systems to support the verification of provider status and requirements.
• Participates in special initiatives, audits, and other organizational activities related to the network, following regulatory requirements from local and federal agencies
• Perform tasks using the appropriate operational software platforms relevant to the unit’s functions, such as Customer Relationship Management (CRM), SAI 360, and Credentialing Digital Platform from the Office of Insurance Commissioner, National Practitioner Data Bank, Puerto Rico Medical Licensing Board, and or any other internal or external platform upon request.
• 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 in Secretarial Science, Office Systems, or Business Administration. At least six (6) months of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

OR

Education and Experience: Associate's Degree or at least sixty to sixty-four (60-64) approved college credits. At least one (1) year of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

OR

Education and Experience: High School Diploma or Technical Course. At least two (2) years of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: Not required.

Other: N/A

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.”