Network Operations Coordinator

Triple-S; Guaynabo (PR); On-site; USD 42,000 - 65,000; Full time

Job summary

Triple-S is seeking a Network Operations Coordinator to manage the intake and triage of operational requests, coordinate assignments, and maintain dashboards for real-time visibility across workflows. The role supports audit readiness and ensures alignment with URAC-NCQA accreditation standards while working across divisions to drive process efficiency.

Qualifications include a Bachelor's degree in Business Administration or Health Services Administration and 1–3 years of related experience in

Qualifications

• Bachelor's degree in Business Administration or Health Services Administration.
• 1–3 years of experience in project coordination, business analysis, network administration, healthcare compliance, or related fields.
• Knowledge of URAC-NCQA accreditation standards is preferred.

Responsibilities

• Manage the end-to-end intake process for operational requests, ensuring accurate documentation, prioritization, and timely acknowledgment.
• Perform initial evaluation and triage of incoming requests to determine scope, urgency, and required actions.
• Assign tasks to appropriate teams or stakeholders based on predefined criteria, or elevate issues as needed to ensure prompt resolution.
• Maintain and continuously update dashboards, trackers, and documentation to provide real-time visibility into request status, progress, and outcomes.
• Ensure proper follow-up and closure of all assigned items, validating that deliverables meet established standards and requirements.
• Assist in audit preparation activities, including evidence gathering, documentation review, and coordination of audit-related deliverables.
• Identify and assess requirements based on local and external regulations, contract changes and business needs.
• Collaborate cross-functionally to ensure alignment, resolve dependencies, and improve process efficiency.

Skills

Action Oriented

Collaborates

Customer Delight

Instills Trust

Manages Ambiguity

Education

Bachelor's Degree in Business Administration or Health Services Administration

Job description

At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.

When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

Let's build healthier communities together,

Job Summary

The Network Operations Coordinator plays a critical role in ensuring the efficient execution and continuous improvement of operational processes. This position is responsible for managing the intake and triage of operational requests, conducting initial general assessments, and coordinating the appropriate assignment or escalation to relevant teams or stakeholders. The role requires strong organizational, documentation, and communication skills to maintain visibility across workflows, drive timely resolution of tasks, and support operational excellence. Additionally, the Operations Coordinator oversees tracking mechanisms, maintains dashboards and documentation, monitors key performance metrics, and contributes to audit readiness and reporting deliverables. This role serves as a central point of coordination, ensuring alignment, accountability, and consistency across operational activities.

Essential Functions

• Manage the end-to-end intake process for operational requests, ensuring accurate documentation, prioritization, and timely acknowledgment.
• Perform initial evaluation and triage of incoming requests to determine scope, urgency, and required actions.
• Assign tasks to appropriate teams or stakeholders based on predefined criteria, or elevate issues as needed to ensure prompt resolution.
• Maintain and continuously update dashboards, trackers, and documentation to provide real-time visibility into request status, progress, and outcomes.
• Ensure proper follow-up and closure of all assigned items, validating that deliverables meet established standards and requirements.
• Assist in audit preparation activities, including evidence gathering, documentation review, and coordination of audit-related deliverables.
• Identifies and conducts assessments of requirements based on local and external regulations, contract changes and business needs.
• Ensures URAC-NCQA accreditation standards are incorporated and maintained.
• Support the development and maintenance of standard operating procedures (SOPs), process documentation, and division policies.
• Collaborates and provides guidance in the design of efficient and compliant metrics. Performs operational monitoring of processes and key performance metrics. Conducts compliance surveillance for the division to ensure that regulatory requirements are followed.
• Monitors compliance metrics and recommends appropriate actions.
• Collaborate cross-functionally to ensure alignment, resolve dependencies, and improve process efficiency.
• Assists in the process improvement analysis and redesign for procedures and working practices.
• Coordinates activities-projects of low to medium level of complexity. Develops, monitors and reports work plans and activities in the critical path for projects-tasks assigned.
• Coordinate meetings, track action items, and ensure follow-through on operational commitments. Conducts training and development activities for the division especially but not limited to regulations.
• Provide general administrative and operational support as needed to ensure smooth day-to-day operations.

Education

• Bachelor's Degree in Business Administration or Health Services Administration

Experience

Bachelor’s degree, preferably in Business Administration, Health Service Administration or in related areas, with one (1) to three (3) years of experience in project coordination, business analysis, network administration, healthcare compliance, or related fields.

Licences and Certifications

• None required

Competencies

• Action Oriented
• Collaborates
• Customer Delight
• Instills Trust
• Manages Ambiguity

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.