Senior Healthcare Exchange Analyst

Unimed Nacional

. Act as the first point of contact for Unimed requests related to Account Reversal, critical analysis of potentially improper billing, and Exceptional Care.

Posted 10/30/2026full-timeSão Paulo • BrazilSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing healthcare network adequacy, negotiating with providers, and ensuring compliance with healthcare regulations. Proficient in managing exceptional care cases and collaborating across departments to facilitate timely care for beneficiaries.

Highest-signal resume keywords

Negotiation SkillsProvider CredentialingHealthcare ManagementRegulatory ComplianceAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Critical AnalysisProcess ImprovementAccount ReversalExceptional Care ManagementProvider Prospecting

Soft Skills

CollaborationCommunicationProblem-Solving

Tools & Technologies

CNU SystemsUnimed do Brasil SystemsMicrosoft OfficeGoogle Sheets

Certifications & Qualifications

Bachelor's DegreeMBA or Postgraduate Qualification

Industry Keywords

National Healthcare Exchange ManualANS RegulationsCustomer Service DeadlinesOccupational Health Standards

About the role

Key responsibilities & impact

Act as the first point of contact for Unimed requests related to Account Reversal, critical analysis of potentially improper billing, and Exceptional Care.
Conduct a comprehensive analysis of Unimed network adequacy scenarios for requests originating from Commercial Relations.
Monitor Exceptional Care cases from the signing of the agreement through full settlement of the account.
Act as the second-level point of contact for requests involving Guarantees of Care, NIPs, and court injunctions, ensuring care is provided, making provider networks available, or supplying information to the responsible teams.
Facilitate timely care for CNU beneficiaries through the local accredited network or by negotiating one-time arrangements for consultations, tests, therapies, procedures, and hospitalizations.
Strategically identify and negotiate with partner providers in critical and/or high-cost care regions.
Maintain collaboration with the Customer Service Center, NAC, Litigation Legal, Medical Regulation, Commercial, Relationship Management, Direct Network, IT, and other departments.
Analyze processes and recommend solutions to reduce the volume of FDAs, NIPs, and court injunctions.
Use CNU and Unimed do Brasil systems to process requests.
Keep the immediate supervisor informed about incidents, solution progress, and improvement suggestions.
Comply with internal regulations, quality requirements, ANS regulations, and occupational health, hygiene, and safety standards.

Requirements

What you’ll need

Bachelor’s degree completed.
Field of study: Business Administration, Healthcare Management, Accounting, Economics, or related fields.
MBA or postgraduate qualification in Healthcare, People Management, or related fields.
Knowledge of the National Healthcare Exchange Manual and the RNs related to customer service deadlines.
Experience in negotiations, provider prospecting, and provider credentialing.
Knowledge of Microsoft Office and Google Sheets.

Benefits

Comp & perks

Medical Insurance: Outpatient, hospital, and maternity coverage for you and your eligible dependents.
Dental Insurance: Company-subsidized plans covering services from basic procedures to orthodontics and prosthetics.
Pharmacy Benefit: Convenient access to discounted medication purchases at participating pharmacies, with payroll deduction and a limit based on salary.
Wellhub (Gympass): Wellness platform providing access to gyms and health apps, extendable to up to three dependents.
Meal Card: Daily allowance credited for each working day to cover meals.
Food Card: Monthly allowance to help cover grocery purchases.
Private Pension Plan: Company-sponsored plan to help build financial reserves and future income.
Life Insurance: Death and disability coverage providing financial protection for you and your family.
PPR (Profit-Sharing Program): Annual reward based on achievement of the cooperative’s collective goals.
Transportation Allowance: Available for commuting between home and work under on-site or hybrid arrangements.
Parking: Partnerships with parking facilities near company locations.
Birthday Day Off: One day of leave granted after your birthday for you to enjoy as you wish.
Family Support: Daycare or nanny allowance for employees with children up to 16 months old.
Benefits Club: Partnerships and discounts at educational institutions, language schools, and leisure venues.