Unimed Nacional

Analyst

• Develop and implement the compensation strategy by analyzing market trends and aligning it with strategic objectives to ensure competitiveness and internal equity.
• Lead projects involving the review and implementation of compensation policies, coordinating teams and resources.
• Implement and ensure compliance with Collective Bargaining Agreements (CBAs), interpreting CBA provisions and adjusting internal policies to ensure legal compliance and prevent labor liabilities.
• Provide strategic consulting to senior leadership, presenting analyses and recommendations to support critical business decisions.
• Conduct benchmarking of compensation practices.
• Perform cost analyses of compensation policies using financial models while ensuring financial viability.
• Implement compensation governance practices by establishing clear policies and procedures to ensure transparency and compliance.
• Effectively communicate compensation policies across all levels of the organization by developing communication materials and leading informational sessions.

Senior Compensation Analyst

• Support the establishment of parameters for the standardization and control of products related to the processing of services within Central Nacional Unimed’s accredited network and the National Interchange, working under guidance.
• Register items based on data published by regulatory bodies and information owners (ANS, Unimed do Brasil, and Commercial Departments) through the relevant systems.
• Configure rules established by regulatory bodies and negotiated agreements, in accordance with guidelines.
• Assist with requests for the creation of new codes, classification changes, corrections, and information required by regulatory bodies.
• Update product pricing in the internal healthcare management system based on Simpro, Brasíndice, CBHPM, and Unimed do Brasil.
• Establish coding relationships among the tables used for standardization.
• Support the analysis and updating of business rules published by regulatory bodies and information owners.
• Provide the information required for system implementation involving authorization, payment, and billing for contracted services.
• Provide support to operational departments, including Medical Accounts, Billing, and the Contact Center.
• Prepare standardized supporting documentation covering medical and nursing technical criteria, ANS and Unimed do Brasil business criteria, and commercial criteria.
• Prepare and deliver presentations on implemented parameters and new configurations.
• Comply with internal regulations, quality management system requirements, ANS regulations, and occupational health, hygiene, and safety standards, including the use of PPE/PPC when required.
• Perform other activities inherent to the position or assigned by the immediate supervisor, when qualified.

Junior Business Rules Analyst

Supervisor

• Supervise the area’s medical and nursing operations, ensuring compliance with the health plan operator’s policies and applicable legislation.
• Guide the team in achieving results, productivity, and quality targets.
• Ensure compliance with deadlines for concurrent audit and medical billing processes.
• Oversee the operations and deliverables of outsourced teams providing services to the health plan operator.
• Follow up on findings, lead negotiations, and monitor the resolution of cases involving adverse events.
• Support the team in discharge planning and provide technical nursing support to the local audit team.
• Support the coordination team in implementing and maintaining the DRG system, as well as monitoring the area’s performance indicators and targets.
• Participate in meetings with the audit, quality, and patient safety teams at accredited hospitals to discuss cases.
• Identify negotiation opportunities and contribute to the development of continuous improvements.
• Manage all people-related activities, including attendance tracking, vacation scheduling, training, and feedback, promoting performance management in partnership with HR.
• Ensure compliance with internal regulations, quality requirements, ANS regulations, and occupational health and safety standards.
• Liaise with other company departments to enhance the efficiency and performance of activities.
• Monitor key indicators, such as average length of hospital stay.

Concurrent Audit Supervisor

Customer Support

• Conduct customer satisfaction surveys from deployment through analysis of the results.
• Analyze customer data and feedback, identifying trends, patterns, and opportunities for improvement.
• Create periodic presentations that translate data into insights and support a customer-centric culture.
• Support customer engagement initiatives and the ongoing enhancement of the customer experience.
• Collaborate with peer departments across the organization to drive improvement initiatives forward.

Customer Experience Analyst, Mid-Level

Claims Specialist

• Analyze less complex medical claims, hospital claims, disputes, and appeals of claim denials submitted by healthcare providers and the Unimed System
• Analyze and release pre-analysis workflows in the management system
• Enter service data and arrange billing and rebilling
• Receive, organize in spreadsheets, and archive invoices
• Generate analytical reports and release processes to the Finance department
• Verify compliance with ANS regulatory requirements, the National Interchange Manual, and contractual rules
• Check amounts against reference tables and make the necessary adjustments
• Monitor billing deadlines and manage late billings
• Record decisions with appropriate justifications and validate signatures from other departments
• Provide support to healthcare providers and contracted providers regarding claims and appeals
• Request corrections to invoices and CMB and XML Portal files containing inconsistencies
• Propose improvements to operational workflows and stay up to date on internal standards and processes

Junior Medical Claims Analyst

• Develop and execute structured financial transactions.
• Model and assess the financial feasibility of funding transactions.
• Identify and negotiate credit facilities with financial institutions and investors.
• Compare cost, term, and collateral alternatives, recommending the optimal structure.
• Manage the portfolio of short- and long-term financial investments.
• Analyze products, rates, risks, and liquidity to maximize returns while maintaining security.
• Ensure compliance with the investment policy, the company’s risk profile, and ANS regulations.
• Maintain relationships with banks, fintechs, and capital markets participants.
• Prepare and update short-, medium-, and long-term cash flow projections.
• Monitor inflows and outflows, anticipating funding requirements.
• Monitor variances and propose corrective actions aligned with the company’s strategy.
• Support the monthly financial close and audits, ensuring financial reconciliation.
• Generate decision-making insights using data analysis tools.
• Lead process improvement and automation projects.
• Support the development of other analysts and serve as a point of contact.
• Oversee, manage, and drive the continuous improvement of the team’s activities.

Senior Treasury Analyst

Compliance

• Continuously monitor operations throughout the entire work period.
• Receive and triage requests through the TOP system, verifying patient eligibility, coverage, waiting periods, and provider documentation.
• Record requests in a spreadsheet, tracking eligibility, pending items, and other relevant information.
• Maintain telephone contact with beneficiaries to provide updates and clarification.
• Centralize communication among emergency services, hospitals, medical transportation units, and other agencies.
• Refer cases to the medical team responsible for assessment.
• Update system codes based on medical confirmations.
• Handle emergency and crisis situations by applying contingency procedures and making quick decisions.
• Assist beneficiaries in cases of coverage denial, including coordinating and arranging an ambulance when necessary.
• Evaluate regulatory processes, identify opportunities for improvement, and propose corrective and innovative measures.
• Participate in training on regulatory procedures and crisis management.