Top 237 Registered nurse Jobs in Caguas, Pr

Operations Manager (Payment Integrity) - San Juan, PR
UnitedHealth Group —San Juan, PR
- Overtime
- Microsoft Excel
- Microsoft Outlook
- RN License
14d
Registered Nurse (RN-BSN)
NeoMed Center Inc —Gurabo, PR
- $20.72 - $22.88 an hour
- Overnight shift
- Dental insurance
- 401(k)
Quick Apply
14d
Registered Nurse - Home Visits
Alura Workforce Solutions —San Juan, PR
- $45 an hour
- Part-time
- Patient monitoring
- RN License
- Mid-level
Quick Apply
Registered Nurse (RN)
Business Staffing Solution —Aibonito, PR
- From $30 an hour
- 12 hour shift
- Nursing
- Vital signs
- Management
Quick Apply
Clinical Research Nurse, RN
Headlands Research —San Juan, PR
- Full-time
- Spanish
- Patient monitoring
- RN License
- Health savings account
- Paid holidays
Quick Apply
Enfermeros(as) Contratistas RN | ADN | BSN
MED Solutions Consultin Group, LLC —Bayamón, PR
- $16 - $17 an hour
- Part-time
- Flexible schedule
Quick Apply
5d
Profesor(a) Bachillerato en Ciencias de Enfermería (RN a BSN)
NUC University —San Juan, PR
- Part-time
Quick Apply
Especialista De Determinaciones Organizacionales Y Apelaciones
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Nursing
- RN License
Especialista en Revision Medica
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Nursing
- RN License
Registered Nurse (RN)
PROVIDER NETWORK SOLUTIONS OF PUERTO RICO LLC —San Juan, PR
- Full-time
- Home Health
- 401(k)
Quick Apply
7d
Risk Adjustment and Coding Nurse
TPIS —San Juan, PR
- $55,000 - $65,000 a year
- Temporary
- Spanish
- Nursing
- RN License
Quick Apply
Charge Nurse
San Juan Capestrano —Rio Piedras, PR
- Full-time
- CPR Certification
- Nursing
- Addiction Medicine
1d
Enfermero(a) Generalista - RN
Hospital Oncológico —San Juan, PR
- Full-time
- In-person
Quick Apply
7d
Director of Nursing
NeoMed Center Inc —Gurabo, PR
- $24.69 - $26.07 an hour
- Extended hours
- CPR Certification
- Nursing
- PALS Certification
- Free parking
- Continuing education credits
Quick Apply
Intake RN (San Juan)
Revival Home Health Care a Centers Company —San Juan, PR
- Full-time
- Mid-level
- Home Health
- Discharge planning
Quick Apply
Enfermero/a Generalista Servicio Profesionales
Hospital Menonita Guayama —Guayama, PR
- $17.30 an hour
- Contract
- CPR Certification
- Nursing
- Anatomy knowledge
Quick Apply
Registered Nurse - Admissions
San Juan Capestrano —Rio Piedras, PR
- Full-time
- CPR Certification
- Nursing
- RN License
1d
Registered Nurse
Solace Clinical Research —Bayamón, PR
- $13 - $16 an hour
- Full-time
- Vital signs
- Urgent Care
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
QA Monitoring Nurse Reviewer -Regular- CMS Carolina- #2609
Clinical Medical Services —Carolina, PR
- Full-time
- Home Health
Quick Apply
Registered Nurse Care Navigator Bilingual English/Spanish
Duo Health —San Juan, PR
- Monday to Friday
- Background check
- Spanish
- Nursing
- Travel reimbursement
- Mileage reimbursement
Quick Apply

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registered nurse jobs near caguas, pr

Operations Manager (Payment Integrity) - San Juan, PR

UnitedHealth Group -
San Juan, PR

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Job Details

14 days ago

Qualifications

Healthcare financial misconduct investigations
Performance dashboards
Microsoft Excel
Microsoft Outlook
Team supervision
Regulatory compliance
English
Medical claims processing software
Healthcare billing investigations
Leading team collaboration initiatives
Managing projects
Financial performance measurement
Healthcare performance metrics analysis
Healthcare compliance

Full Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Manager of Administrative Coding is part of the leadership team overseeing Optum's Behavioral Payment Integrity (PNI) Operations; specific to Fraud, Waste, Abuse, & Error (FWAE) investigations. This position is responsible for the strategic direction and execution of the Optum Behavioral administrative coding review team.

Primary Responsibilities:

Lead and develop a team responsible for resolving complex provider inquiries, escalations, and Payment Integrity operational issues
Establish and maintain trusted relationships with senior internal and external stakeholders, including UHN, UHC Payment Integrity, Network Management, and Provider Relations partners
Drive resolution of high-priority escalations through collaboration with Operations, Analytics, Reporting, Medical Directors, Compliance, and Legal partners as appropriate
Facilitate executive-level meetings, discussions, and Q&A sessions with leadership stakeholders
Monitor production, quality, turnaround time, service-level agreements, and operational performance metrics to ensure successful delivery of business objectives
Prioritize work queues and implement contingency plans when operational targets are at risk
Lead root cause analysis and corrective action planning to address recurring operational issues and improve performance outcomes
Analyze trends, performance data, and operational metrics to identify opportunities for process improvements, efficiency gains, and risk mitigation
Partner with business leaders to anticipate future operational needs and support workforce planning strategies
Develop executive presentations, business reviews, and leadership materials that communicate operational performance, risks, opportunities, and strategic recommendations
Influence and drive alignment across multiple business functions without direct authority
Supervise, coach, mentor, and develop a team, fostering a culture of accountability, engagement, and continuous improvement
Partner with global and enterprise stakeholders to support strategic initiatives, operational objectives, and business growth opportunities

***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

3+ years of experience in provider-facing, client-facing, or healthcare operations leadership roles
2+ years of people management experience
2+ years of experience utilizing operational metrics, analytics, dashboards, and performance measures to drive business outcomes
Experience leading operational improvements in a healthcare, claims, or Payment Integrity environment
Experience working within healthcare compliance and regulatory requirements
Experience developing business cases, managing projects, and achieving measurable operational or financial results
Experience partnering with senior leaders and navigating matrixed organizations
Experience with Fraud Waste & Abuse or Payment Integrity
Knowledge of healthcare claims platforms and end-to-end claims operations
Proficiency with Microsoft Office Suite, including Excel, PowerPoint, Word, and Outlook
Professional proficiency in English
Demonstrated ability to work a flexible schedule during normal business hours and support occasional overtime or weekend business needs
Demonstrated ability to manage competing priorities in a fast-paced, high-change environment

Preferred Qualifications:

Registered Nurse (RN) license
Certified Coder
Experience with provider relations, network management, or network contracting practices
Experience managing budgets and financial performance
Experience developing and executing growth, operational excellence, or transformation strategies

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Refine Your Search

registered nurse jobs in caguas, pr

Operations Manager (Payment Integrity) - San Juan, PR

Registered Nurse (RN-BSN)

Registered Nurse - Home Visits

Registered Nurse (RN)

Clinical Research Nurse, RN

Enfermeros(as) Contratistas RN | ADN | BSN

Profesor(a) Bachillerato en Ciencias de Enfermería (RN a BSN)

Especialista De Determinaciones Organizacionales Y Apelaciones

Especialista en Revision Medica

Registered Nurse (RN)

Risk Adjustment and Coding Nurse

Charge Nurse

Enfermero(a) Generalista - RN

Director of Nursing

Intake RN (San Juan)

Enfermero/a Generalista Servicio Profesionales

Registered Nurse - Admissions

Registered Nurse

QA Monitoring Nurse Reviewer -Regular- CMS Carolina- #2609

Registered Nurse Care Navigator Bilingual English/Spanish

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