Puerto Rico careers

Launch a career that makes a difference

If you are a leader, creator, or innovator looking to ignite your career and find a rewarding sense of purpose, we want to hear from you.  

 

Carelon Global Solutions houses knowledgeable, bilingual, best-in-class call center agents who collaborate to support our clients’ needs and help solve healthcare’s most complex challenges. 

 

At the heart of this great endeavor are people — the kind of people who embody diverse ways of thinking and who come to work each day with determination and curiosity.

Current Openings

Job Title: Bilingual Customer Service Representative
Job Category: Entry Level
Position Type: Full Time
Location: San Juan, PR

Job Description:

  • Responsible for successfully completing the required basic training.
  • Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
  • Must pass the appropriate pre-employment test battery.
  • Primary duties may include, but are not limited to:
  • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
  • Analyzes problems and provides information/solutions.
  • Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
  • Thoroughly documents inquiry outcomes for accurate tracking and analysis.
    Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
  • Researches and analyzes data to address operational challenges and customer service issues.
  • Provides external and internal customers with requested information. Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
  • Uses computerized systems for tracking, information gathering and troubleshooting. Seeks, understands and responds to the needs and expectations of internal and external customers.

Requirements:

  • Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims.
  • Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.
  • Bilingual (Spanish) or multi-language skills required.
  • Must be able to pass a validated language test/assessment.
  • Strong communication skills (bi-lingual)
  • Excellent computer skills (able to navigate in multiple applications); fast typing skills
  • Good problem-solving skills – investigating issues and driving effective problem resolution
  • Healthcare experience (preferred)

 

Use this link to submit your resume via email.

Job Title: Facilities Manager
Job Category: Exempt - Salaried
Position Type: Full Time
Location: San Juan, PR

Job Description:

  • Responsible for providing oversight for the facilities organization at a specific facility, set of buildings, or campus environment.
  • Primary duties may include but are not limited to: charged with the day-to-day implementation of policies, procedures and programs that will assure a well-managed, well-maintained building, placing maximum emphasis on positive response to the concerns and needs of the associates tenants, environmental health and safety, and quality programs, in coordination and conjunction with Carelon Global Solutions and Elevance the Owner's goals and objectives; coordinates the activities, financials, vendors and manpower.
  • Ensures day-to-day operations of the facility(s) or campus including janitorial, life-safety, engineering and general maintenance are implemented and carried out in a manner consistent with company policies and ownership directives; ensuring all contracts are reviewed on a regular basis and are bid out as needed and assures invoices match contract pricing.
  • Oversee all maintenance operations relating to the interior and exterior conditions and appearance of the properties.
  • Ensure all site documentation and reports are completed accurately and on time, including: Property Information Book, Site Operating Manual, Emergency Procedures Manual, IIPP Manual, Local Code Compliance Log, ADA Compliance Log, OSHA Log, Safety Meeting Log, Elevator Logs, Janitorial Log, Purchase Order Log, Vendor Certificates of Insurance, As-built Drawings, IIPP Manual, Paid Invoices File, General Files, Contract Files, Annual Property Conditions and Year-end Performance Report, and other reports and documentation as required.
  • Prepares, reviews, and gives initial approval and as needed all budgets, financial reports (monthly and quarterly), contracts, expenditures and purchase orders related to the facility(s) or complex. Coordinate the preparation and publication of the annual budget, quarterly reforecast, and business plans. Assist in the development of capital budgets for the property.
  • This includes contributions towards a five-year plan of maintenance, facility improvement, and cost reduction initiatives.
  • Responsible for the collection, analysis and reporting of such statistical data as may be required to provide accurate and current assessment of facility management objectives.
  • Ensure that at tenants and vendors comply with insurance requirements and coordinate all claims as needed.

Requirements:

  • Requires a BA/BS degree in Business or related field of study and a minimum of 8 years of experience in Corporate Real Estate, Facilities Management, Data Center Critical Infrastructure, construction, and advanced built environment technologies; or any combination of education and experience, which would provide an equivalent background.
  • Experience in Engineering, Construction Management or related field of study is strongly preferred. Active participation in industry leading trade associations to include, but not limited to BOMA, IFMA, CORENET, USGBC, WELL, FITWEL, IREM, UPTIME, AEE strongly preferred.

 

Use this link to submit your resume via email.

Job Title: Performance Quality Analyst I
Position Type: Full Time
Location: San Juan, PR

Job Description:

The Performance Quality Analyst I is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to customer service written and verbal inquiries. Primary duties may include, but are not limited to:

  • Assists higher level auditor/lead on field work as assigned, including performing special audits and targeted audits as requested by internal management.
  • Participates in pre and post implementation audits of member inquiries and the corrective action plan process.
  • Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
  • Documents audit results, documents findings, and suggests appropriate remediation.
  • Provides coaching and education to frontline staff on audited inquiries and identified opportunities for improvement.

Requirements

  • Requires a BS/BA
  • 2+ years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector) or any combination of education and experience, which would provide an equivalent background.
  • Analytical and problem-solving skills.
  • Decision-making skills.
  • Challenge the status quo.
  • Excellent verbal and written communication skills.
  • Adaptability and flexibility.
  • Collaborative and team oriented.
  • Ability to provide effective coaching to others.
  • GBD call center experience with Medicare products strongly preferred.

 

Use this link to submit your resume via email.

Job Title:Performance Quality Analyst II
Position Type: Full Time
Location: San Juan, PR

Job Description:

The Performance Quality Analyst II is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to customer service written and verbal inquiries. Primary duties may include, but are not limited to:

  • Assists higher level auditor/lead on field work as assigned and acts as auditor in charge on small and less complex audits.
  • Participates in pre and post implementation audits of member inquiries and the corrective action plan process.
  • Demonstrates ability to audit multiple lines of business, multiple functions, and multiple systems.
  • Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
  • Works closely with the business to provide consultation and advice to management related to policy and procedure identified as out of date or incomplete and investigates, develops and recommends process improvements and solutions.
  • Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process.
  • Acts as a mentor to peer auditors, providing training and managing work and projects as necessary.
  • Provides coaching and education to frontline staff on audited inquiries and identified opportunities for improvement.

Requirements:

  • Requires a BS/BA
  • 3+ years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector)
  • Minimum of 1 year related experience in a quality audit capacity or any combination of education and experience, which would provide an equivalent background
  • Ability to build relationship and influence others
  • Creativity and critical thinking skills
  • Analytical and problem-solving skills
  • Sound decision-making skills
  • Challenge the status quo
  • Excellent verbal and written communication and presentation skills
  • Adaptability and flexibility
  • Collaborative and team oriented
  • Ability to provide effective coaching to others
  • GBD call center experience with Medicare products strongly preferred.

 

Use this link to submit your resume via email.

Job Title: Configuration Engineer
Work location: Remote
Work schedule: M-F normal business hours
Location: San Juan, PR

Description:

As defined by ITIL, the Configuration Manager oversees the quality and integrity of day-to-day process execution. The Configuration Manager is responsible for ensuring that the process execution is in line with the process design, as defined by the Configuration Management Process Owner.

 

Typically, large companies require multiple people working as Configuration Managers. One Configuration Manager should be set up to oversee a manageable work volume. “Execution work volume” and organizational structure are the key factors in deciding how many Configuration Managers are needed. This role is responsible for:

  • Providing oversight of daily execution of the Configuration Management Process 
  • Defining measurements and controls 
  • Assisting in defining Configuration Management plans, standards and procedures 
  • Determining technology needs. Evaluates existing Configuration Management Systems and the design, implementation and management of new/improved systems. 
  • Identifying process roles and responsibilities and manages staffing of these roles 
  • Creating project proposals as needed 
  • Collecting feedback on the process and assessing process effectiveness and efficiency 
  • Recommending initiatives and communicating to stakeholders 
  • Selecting and proposing CIs to be uniquely identified. Ensures that staff complies with identification standards 
  • Proposing and/or agrees to interfaces with Configuration Management System (CMS) data sources, Change Management, Incident Management, IT Asset Management and other processes as needed 


Qualifications Requirements

  • BA/BS degree or technical institute training, or any combination of education and experience, which would provide an equivalent background. 
  • Experience with business and technical applications. 
  • Experience driving projects to completion 
  • Strong Java Development experience is required


Desired Skills

  • Good understanding of corporate IT policies, procedures, and standards 
  • Knowledge of the Configuration Management process and interfacing processes
  • Management and analytical skills
  • Knowledge of Service Level Commitments
  • Customer relationship skills
  • Knowledge of the IT organization and business processes
  • Good oral and written communications skills
  • Conflict management skills
  • Able to monitor and manage progress of tasks
  • Effective negotiation skills
  • Ability to identify problems and note trends
  • Broad understanding of the technical IT environment

 

Use this link to submit your resume via email.

Job Title: Financial Consultant
Work location: Hybrid
Work schedule: M-F normal business hours
Location: San Juan, PR

Job Description:

The Financial Consultant is responsible for preparation, interpretation, and communication of monthly/quarterly/annual financial results; forecast & budgeting exercises; internal and/or customer-focused financial modeling and presentation. Performs consulting services to support business development studies, economic evaluation, and planning functions.

 

Primary duties may include, but are not limited to:

  • Identifies complex financial problems or issues, research solutions, and implements corrective steps to achieve higher level of efficiency.
  • Advises management of various financial models and recommendations.
  • Prepares complex presentations & effectively communicates with business leadership.
  • Prepares financial planning, financial section of annual and quarterly reports to shareholders, applicable government reports, and budget reports. 
  • Reviews and prepares interpretation of historical financial data, financial projections, and results.
  • Performs consulting services to support planning functions.
  • Prepares analysis of results for lines of business to support allocation reviews.
  • Identifies and prepares monthly journal entries in support of the month end close process.
  • Identifies and creates solutions to complex financial problems or issues.
  • Researches solutions and implements corrective steps to achieve higher level of operational & financial efficiency
  • Prepares pricing and financial modeling that reflects the proper costs and margins needed for profitable business
  • Trains and reviews the work of lower level Financial Analysts.

 

Minimum Requirements

Requires a BA/BS in accounting, finance or economics and a minimum of 3 years’ experience in general accounting, finance, pricing, ROI or budget and planning; or any combination of education and experience, which would provide an equivalent background.

 

Preferred Skills, Capabilities, and Experiences

  • MBA, CPA, or CMA preferred.
  • Strong analytical skills.
  • Ability to work independently as well as a part of a team to support the business.
  • Strong experience with Microsoft Excel.
  • Experience with Hyperion Smart view/Planning and Peoplesoft GL.

 

Use this link to submit your resume via email.

Job Title: QA Engineer – Spanish Testing
Work location: Remote
Work schedule: M-F normal business hours
Location: San Juan, PR

 

Background Information:

Spanish testing is a critical part of the document testing specifically on the Summary of Benefits (SOB), which gives a brief overview of various benefits, and the cost share details across our network providers, and Summary of Benefits and Coverage (SBC), which gives detailed overview of benefits and their coverage details across providers.

 

The scope of testing involves ensuring that any changes that happen in SBC and SOB English templates and incorporated in both SBC and SOB Spanish templates are validated to ensure that the language in Spanish documents print correctly and accurately.

 

To effectively test this requires both good English and Spanish language skills with testing experience towards validating Spanish document and ensuring it conforms to the English version of documents or templates in texts, verbiage, and all specifications.

 

Quality Assurance (QA) Engineer:

Required Experience and Abilities

  • 3 – 5 years of bilingual testing experience (English & Spanish).
  • Hands on testing experience on web-based applications.
  • Demonstrated ability to perform and manage test execution activities in both English and Spanish.
  • Possess strong analytical skills, organizational skills, attention to detail, and excellent verbal and written communication skills in both English and Spanish languages.
  • Ability to establish and maintain effective working relationships with co-workers, managers and internal and/or external customers.
  • Strong knowledge of agile process.
  • Strong experience in validating Spanish document and ensuring that it conforms with English version and specifications.

 

Required Technical Skill Set

Must have:

  • Solid background and hands-on experience reviewing requirement/user stories and design while creating test assets and performing testing execution.
  • Experience using testing tools like Jira, Confluence, and MS SharePoint is required.
  • Software analysis, design, and testing knowledge and experience.
  • Experience working in Agile Kanban methodology testing environment.
  • Excellent written and verbal English and Spanish skills with experience in validating Spanish document to ensure it aligns with English version and translation is required.
  • Strong English and Spanish language skills with work experience demonstrating meticulous attention to details.
  • Ability to work under pressure and tight deadlines while ensuring all details in English version are correctly and appropriately captured in Spanish language on documents.

Nice to have:

  • Knowledge of healthcare systems and testing health care insurance products and systems is an asset. 
  • Previous experience validating Spanish documents and ensuring it conforms to English version is an asset.
  • Quality Certification such as CSTE, CSQA, CMST, and CSQE is an asset.
  • Agile Certification, such as SAFe Practitioner (SP), etc is an asset.

 

Responsibilities

  • Engages in the testing of Spanish documents for small to medium initiatives to ensure the Spanish texts, verbiage, and specifications aligns with the English documents or templates.  
  • Identifies, creates, and executes the appropriate test assets - plans, cases, scripts, and metrics to assure the developed application conforms to requirements and design.  
  • Coordinates and executes Spanish testing across multiple testing phases.  
  • Defines appropriate testing methods to employ to assure Spanish document output developed conforms to English documents requirements and design.  
  • Ensures all applicable SDLC and testing processes are followed, while executing linkage from test plan to test scenarios and test cases. 
  • Collaborates with the Spanish Test Lead in the creation and the communication of all testing deliverables. 
  • Coordinates, identifies, and executes test cases while reviewing defects towards assessing application quality.
  • Leads defect triage relating to Spanish testing for smaller or medium initiatives.
  • Prepare testing metrics, reports status as defined in test plan with supporting data. 
  • Defines required tests and corresponding test data based on requirements, design, and technical specifications.
  • Identifies and documents most appropriate test techniques and test tools for the level and type of Spanish testing to be performed. 
  • Develops testing documentation (i.e., test cases, test scripts) and obtains approval of all relevant stakeholders. 
  • Works with the assigned agile development scrum/kanban team on the planning and execution of the required Spanish testing activities for agile projects. 
  • Coordinates testing of the Spanish output version of document and template to ensure correct interpretation with the English version while identifying any discrepancies in text, grammar, etc and recommending correction needed to the Spanish document.

 

Use this link to submit your resume via email.

Job Title: Sr. Scrum Master
Work schedule: Remote / M-F normal business hours
Location: San Juan, PR

 

Required Experience and Abilities:

  • Excellent communication, leadership, and coaching skills.  Most be able to engage and mentor individuals at varying levels of agile maturity.
  • Experience in preforming the Scrum Master role for at least three years on multiple teams in differing environments. 
  • Experience and relatable skills in servant leadership, facilitation, situational awareness, conflict resolution, continual improvement, empowerment, and increasing transparency.
  • Knowledge/experience of techniques and approaches, beyond agile core practices and theory, to address gaps in the agile framework: (i.e Lack of engagement, poor sizing, missed commitments, etc.)
  • Experience working with remote/virtual teams in different time zones.

 

Responsibilities:

  • Guiding the team(s) and organization on how to use Agile/Scrum practices to realize effective outcomes.
  • Coach the team(s) on how to self-organize and solution.
  • Assess the team’s agile maturity and coaching them through continuous improvement at a pace that is sustainable and comfortable for the team and organization.
  • Removing impediments 
  • Building a trusting and safe environment which encourages engagement, collaboration and problem-solving.
  • Facilitating discussion, decision making, and conflict resolution.
  • Assisting with internal and external communication, improving transparency, and assisting with corporate transformation.

 

Preferred Skills/Experience (Any of these are a plus)

  • Experience in preforming the Scrum Master role for more than three years on multiple teams, in differing and/or remote environments (organizations)  
  • Experience with multiple agile approaches: SAFe, Kanban, Scrum, XP, etc.
  • Experience with widely utilized agile techniques: Continuous Integration, Pairing, Big Room Planning, etc.
  • Experience with gathering and leveraging metrics: i.e. Burndown, Cycle Time, etc.

 

Use this link to submit your resume via email.

Job Title: Sr Systems Performance Engineer
Work location: Remote
Work schedule: M-F normal business hours
Location: San Juan, PR

 

Essential duties to include, but are not limited to:

  • Leads and coordinates performance engineering for medium to large initiatives.  Collect and document expected system performance and operational characteristics. 
  • Collect and/or prepare test data for test execution. 
  • Develop and execute performance tests including load, stress, endurance, fail-over and interoperability. 
  • Conduct technical analysis of performance test results and production systems, and provide recommendations on performance tuning, systems, and infrastructure. 
  • Identify, report, and review defects in assessing system performance and stability. 
  • Create reports to document performance metrics, test results, analysis and recommendations. 
  • Monitor performance of production systems.
  • Leads peer reviews to ensure the completeness of all test assets created.
  • Understand and follow all applicable SDLC and performance engineering processes. 
  • Resolve performance and stability issues in performance test environment.  Leads performance defect triage. 
  • Plan and coordinate performance engineering efforts in support of key initiatives.
  • Determine level of effort and resource requirements for customer engagements.  Develop performance engineering work plan structure and project schedule.
  • Work with stakeholders to ensure complete understanding of performance and operational requirements. 
  • Review architectural design for performance risks and potential issues. 
  • Prepare capacity analysis when applicable. 
  • Facilitate team efforts across multiple projects and/or systems.  Facilitate improvement of the performance engineer process in the SDLC. 
  • Facilitate resolution of production performance and stability issues.


Qualifications - External

  • Requires Bachelor’s degree in Computer Science or Information Systems; minimum of 7years performance engineering and performance testing experience; or any combination of education and experience, which would provide an equivalent background.
  • Over 5 years of hands on experience with Performance testing tools listed below -
  • Performance Testing Tools - Microfocus LoadRunner with protocols like Web [HTTP/HTML] & Web services [SOAP & REST], HP ALM (Application Lifecycle Management)/HP Performance Center
  • Performance Monitoring Tools - CA Introscope, Splunk
  • Debugging tools - Fiddler/HttpWatch
  • Validating SOAP requests/REST API payloads with SOAP UI/Postman

 

Use this link to submit your resume via email.

Job Title: Technical Project Manager
Work location: Remote
Work schedule: M-F normal business hours
Location: San Juan, PR

 

Enterprise Product team strives to develop benefit solutions aimed to provide a simplified customer experience with improved speed to market while improving quality and lowering operating costs.

 

The SPIDER (Strategic Product Information Data Enterprise Repository) application is a Strategic Product and Benefit system/repository for the enterprise with over 16 integration points.

 

The incumbent will act as a Technical Project Manager on the Enterprise Product Team and oversee the SPIDER Foundation portfolio of work. Will work with business partners to identify and implement multiple technical projects of varying sizes, as defined by Company methodology, such as broad-based information systems, full life-cycle application development and building enterprise applications. Has the ability to manage large projects of at least $10M in size and equal complexity. Directs analysts, software designers and programmers to determine best methods to achieve project objectives. Works with moderate guidance and is responsible for applying project management knowledge, skills, tools and techniques to project deliverables, processes, and systems. Operates within defined parameters using project management methodology.

 

Responsibilities include, but are not limited to:

  • Manages the development of a prescribed planning document
  • Develops project charter
  • Partners with sponsors to secure project approval
  • Develops communication management plan
  • Defines project team roles and responsibilities
  • Develops work plan structure, project schedule and develops deployment plan
  • Leads project meetings; identifies, documents and prioritizes scope changes and facilitates approval process; maintains and updates all project documents
  • Secures the appropriate skill sets for project
  • Sets and manages expectations with team members
  • Provides performance feedback to team members
  • Maintains issue log & facilitates resolution of issues
  • Executes communication plans & regularly reports status
  • Manages and monitors ROI throughout the project lifecycle
  • Tracks and manages time and budget against plan
  • Develops testing strategy
  • Conduct project close-out activities
  • Prepares and participates in quality review checkpoints and obtain/secure and archive necessary approvals
  • Manage and update project plan 


Qualification requirements:

  • Experience in highly integrated multi-tier large scale applications
  • BA/BS in Computer Science, Engineering, or related discipline with IT focus degree 
  • 3-5 years’ experience in broad-based information systems, full life-cycle application development and/or building enterprise applications and/or data warehouse planning and development 
  • Minimum 5 years of project management experience 
  • At least 2 years leading and directing project tasks 
  • Experience communicating with a variety of both business and technology stakeholders and cross-functional groups 
  • Experience with Agile/Scrum software development framework 
  • Experience in creating an effective team environment, building strong relationships, solving problems and issues, resolving conflicts, managing resources in a matrix environment, communicating and influencing effectively at all levels of an organization 
  • Background should include system processes and proficiency with structured design and/or programming methodologies. 
  • Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, and subject matter experts 
  • Excellent organizational and planning skills 
  • Ability to work independently while handling multiple projects with changing priorities and deadlines.

 

Use this link to submit your resume via email.

We’re invested in your well-being 

Our culture and benefits are designed to inspire our associates to do their best work in an environment where they feel valued. 

 

Find out more about our strong emphasis on collaboration, inclusion, and wellness.  

Learn about our culture and benefits