... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
... Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join now! JOB SUMMARY Responsible for effectively promoting our managed care products ...
Senior Compliance Partner
Guaynabo, PR · On-site
... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ... Create executive reports for senior management. ESSENTIAL FUNCTIONS * Serve as subject matter ...
Senior Compliance Partner
Guaynabo, PR · On-site
... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ... Create executive reports for senior management. ESSENTIAL FUNCTIONS * Serve as subject matter ...
IT QA Analyst
Guaynabo, PR · On-site
Triple-S Management Ubicaciones de puesto (breve): Guaynabo, PR Fecha de inicio de publicación: 01 ... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ...
IT QA Analyst
Guaynabo, PR · On-site
Triple-S Management Ubicaciones de puesto (breve): Guaynabo, PR Fecha de inicio de publicación: 01 ... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ...
VPA De Programas Clínicos Y De Calidad En Farmacia
San Juan, PR · On-site
$120 - $180/hr
... Management Program (MTMP), Integrated Diabetes Program, Specialty Pharmacy Interventions, Designated Medical/Prescribing Practitioner (DMP/DPP), and Centers for Medicare and Medicaid Services (CMS ...
VPA De Programas Clínicos Y De Calidad En Farmacia
San Juan, PR · On-site
$120 - $180/hr
... Management Program (MTMP), Integrated Diabetes Program, Specialty Pharmacy Interventions, Designated Medical/Prescribing Practitioner (DMP/DPP), and Centers for Medicare and Medicaid Services (CMS ...
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Manage the inventory of provider educational materials, communication resources, and training ...
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Manage the inventory of provider educational materials, communication resources, and training ...
Network Operations Analyst
Guaynabo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Provides timely information to management regarding status of compliance with guidelines, rules ...
Network Operations Analyst
Guaynabo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Provides timely information to management regarding status of compliance with guidelines, rules ...
Accounting Manager / Controller About the Opportunity PeopleLift is recruiting on behalf of one of ... Experience supporting external audits or Medicare/Medicaid cost report preparation. * Familiarity ...
Accounting Manager / Controller About the Opportunity PeopleLift is recruiting on behalf of one of ... Experience supporting external audits or Medicare/Medicaid cost report preparation. * Familiarity ...
Patient Service Clerk
Caguas, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Anticipate customer needs and channel them with management so that action and/or anticipatory ...
New
Patient Service Clerk
Caguas, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ... Anticipate customer needs and channel them with management so that action and/or anticipatory ...
New
... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ... This position is responsible for managing the intake and triage of operational requests, conducting ...
... Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos comunidades ... This position is responsible for managing the intake and triage of operational requests, conducting ...
Works closely with supervisor/manager to meet objectives, deadlines, and reporting/measurement ... Minimum of two (1) years' experience working with Medicare and Medicaid insurance as well as ...
Works closely with supervisor/manager to meet objectives, deadlines, and reporting/measurement ... Minimum of two (1) years' experience working with Medicare and Medicaid insurance as well as ...
Medicaid Manager information
What does a Medicaid Manager do?
A Medicaid Manager oversees the administration and management of Medicaid programs within a healthcare organization or government agency. They ensure compliance with federal and state regulations, manage budgets, supervise staff, and coordinate services to ensure eligible individuals receive appropriate healthcare benefits. Their role often includes developing policies, monitoring program performance, and collaborating with other departments or agencies to improve service delivery. Medicaid Managers play a critical role in optimizing program efficiency and ensuring quality care for beneficiaries.
What are the key skills and qualifications needed to thrive as a Medicaid Manager?
To thrive as a Medicaid Manager, you need expertise in healthcare administration, regulatory compliance, and Medicaid policy, often supported by a bachelor’s or master’s degree in health administration or a related field. Familiarity with Medicaid Management Information Systems (MMIS), data analytics tools, and relevant certifications such as Certified Professional in Healthcare Quality (CPHQ) are vital. Strong leadership, communication, and problem-solving skills help you effectively manage teams and navigate complex healthcare regulations. These skills ensure efficient program administration, regulatory adherence, and improved healthcare outcomes for Medicaid populations.
What are some common challenges a Medicaid Manager faces when coordinating with healthcare providers and state agencies?
Medicaid Managers often encounter challenges when aligning the diverse requirements of healthcare providers with the regulatory expectations of state agencies. Balancing compliance, timely claims processing, and communication between stakeholders can be complex, especially given frequently changing policies and high caseloads. Successful Medicaid Managers stay proactive by fostering strong relationships, staying up-to-date on policy changes, and implementing efficient workflows to minimize errors and delays. This collaborative approach is essential for ensuring quality care delivery while maintaining program integrity.
What is the difference between Medicaid Manager vs Medicaid Coordinator?
| Aspect | Medicaid Manager | Medicaid Coordinator |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree in healthcare administration, social work, or related field; certifications like Certified Medicaid Planner may be preferred | Often requires similar educational background; certifications are less common but may include Medicaid-specific training |
| Work Environment | Works in healthcare organizations, government agencies, or insurance companies overseeing Medicaid programs | Usually works in healthcare facilities or community organizations assisting with Medicaid enrollment and compliance |
| Responsibilities | Oversees Medicaid program operations, manages staff, ensures compliance, and develops policies | Assists clients with Medicaid applications, explains benefits, and ensures proper documentation |
Medicaid Managers focus on overseeing Medicaid program operations and compliance, while Medicaid Coordinators primarily assist clients with enrollment and benefits. Both roles require similar educational backgrounds but differ in scope and responsibilities.
What are the most commonly searched types of Medicaid jobs in Puerto Rico?
The most popular types of Medicaid jobs in Puerto Rico are:
What job categories do people searching Medicaid Manager jobs in Puerto Rico look for?
The top searched job categories for Medicaid Manager jobs in Puerto Rico are:
Full-time
Re-posted yesterday
Job description
Sales Rep - Medicare Authorized Representative
Company: Triple-S Salud
Job Location (Short): Hatillo, PR
Posting Start Date: 8/25/26
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, join now!
JOB SUMMARY
Responsible for effectively promoting our managed care products designed for persons eligible for Medicare. The Medicare Authorized Representative will grow membership through various sales and marketing initiatives, including conducting face-to-face sales enrollment meetings, communities, and providers education sessions to existing and potential members. Required to follow all company and CMS rules and regulations, and will be monitored regarding volume, quality, accuracy, and demeanor.
ESSENTIAL FUNCTIONS
EDUCATION
EXPERIENCE
LICENSES AND CERTIFICATIONS
COMPETENCIES
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.
We encourage Veterans and Disabled to Apply.
Company: Triple-S Salud
Job Location (Short): Hatillo, PR
Posting Start Date: 8/25/26
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, join now!
JOB SUMMARY
Responsible for effectively promoting our managed care products designed for persons eligible for Medicare. The Medicare Authorized Representative will grow membership through various sales and marketing initiatives, including conducting face-to-face sales enrollment meetings, communities, and providers education sessions to existing and potential members. Required to follow all company and CMS rules and regulations, and will be monitored regarding volume, quality, accuracy, and demeanor.
ESSENTIAL FUNCTIONS
- Responsible for managing an assigned territory to promote and sell TSA products.
- Maintain and establish positive relationships with providers and organizations in the community.
- Follow procedures and timeliness when submitting daily in-home visits reports to Sales Coordinator.
- Report daily production as agreed with Supervisor and Manager.
- Responsible for ensuring the completeness, quality and eligibility criteria of member's application to meet Enrollment Requirements.
- Contact or follow up on current members in order to obtain customer satisfaction.
- Responsible for effectively communicate benefits and enrollment information to potential members; especially those members with special needs due to physical and/and or mental disabilities.
- Ensure all completed applications are submitted within required time frames; complete administrative paperwork to maintain smooth operations and log activities.
- Identify groups, social services agencies and any other community organization to promote products and services.
- Acts as liaison with community advocacy groups that impacts our target population.
EDUCATION
- Bachelor's Degree in Business Administration
EXPERIENCE
- Bachelor's degree in Business Administration and/or Health, preferable, with 1 to 3 years of related experience preferable in the Health Insurance Industry, or associates Degree (60-64 college credits) with 3 to 5 years of related experience preferable in the Health Insurance Industry.
- Or at least 5 years of this work experience in lieu of.
- DOI - Health and Disability License (or ability to request one within first 15 days of employment).
LICENSES AND CERTIFICATIONS
COMPETENCIES
- Action Oriented
- Collaborates
- Manages Ambiguity
- Instills Trust
- Customer Delight (Employee)
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.
We encourage Veterans and Disabled to Apply.