Unimed Nacional

Analyst

• Identify daily the receipt of billing responses or denial reports issued by the payer/operator.
• Establish priorities for execution and set response deadlines for appeals, ensuring process integrity and mitigating negative financial impacts.
• Liaise with support and customer service teams to validate denial annotations.
• Prepare justification reports with accurate information to submit to the payer/operator.
• Support internal teams by reporting weaknesses that caused denials so that clinical or operational processes can be corrected.
• Prepare monthly reports and indicators demonstrating the evolution of denials, and present the action plans applied.
• Work collaboratively with involved areas, focusing on alignment and continuous improvement.
• Resolve possible billing discrepancies with relevant teams promptly, ensuring the appeals response occurs according to contractual agreements.

Denial Appeals Analyst, Mid-level

Auditor

• Provide support for administrative processes across all areas of the organization, covering a variety of tasks such as monitoring activities, registering incoming and outgoing documents, making contacts and handling telephone calls, assisting suppliers, the public and employees from other departments, providing and receiving information, processing various documents from preparation through receipt and authorization and following all required procedures, and preparing reports and spreadsheets according to the guidelines of the area.
• Perform general administrative routines.
• Organize documents and spreadsheets.
• Support Analysts and Coordinators in their areas.
• Provide support to other departments and assist internal and external clients.

Intern – Concurrent Audit

• Monitor, analyze, and quantify healthcare service costs and performance indicators of accredited providers, in-house resources, and providers within the Unimed network, operating at tactical and strategic levels.
• Build management reports and present identified results and opportunities.
• Analyze concentration of cost metrics, proposing adjustments and process and behavioral improvements to support decision-making.
• Collect and analyze large volumes of data, prepare strategic reports for business areas, and automate database processing to support decision-making.
• Develop new indicators to inform and guide decision-making with a focus on reducing healthcare costs.
• Prepare executive presentations that clearly and concisely translate evaluated data to facilitate decision-making.
• Research and stay up to date on the supplementary healthcare sector.
• Conduct studies on the operation of medical and healthcare systems, as well as population, political, environmental, and cultural behaviors that affect the supplementary healthcare sector in Brazil.
• Produce statistical and predictive models using clustering and classification techniques, develop (or recommend) algorithms, and perform data exploration.
• Map coherence aspects across diverse knowledge domains, identify emerging key elements, and propose the incorporation of innovative elements into practical activities.
• Build customized dashboards to automate recurring analyses.

Strategic Studies Analyst, Mid-level

Bookkeeper

• Analyze hospital medical accounts, disputes, and appeal resources for denials submitted by Providers, reimbursements submitted by beneficiaries and the Unimed System, and arrange the corresponding payments, releasing the payment process to the Finance department, working under guidance;
• Verify that accounts meet regulatory requirements and comply with rules by performing checklists through the system and manual reviews, comparing and verifying amounts against tables/references, and making corrections when necessary;
• Monitor and propose changes, solutions and/or adjustments to workflows, rules in the MIN (Interchange Manual), ANS – National Supplementary Health Agency, and client portfolio invoices, aiming to improve daily processes;
• Maintain records of deliberations/assessments of processes, enter clear justifications for decision-making, check collection deadlines and the presence of signatures on deliberations generated by other areas;
• Enter and analyze provider service data and information in the system; notify any contractual modifications or system changes so that billing analyses can be closed accurately and payments ensured;
• Receive, record in spreadsheets and file invoices for medical service provision, generate analytical reports, and analyze denial appeals and medical accounts;
• Analyze requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities regarding acceptance and payment criteria for Unimeds, Providers and corporate clients;
• Analyze and release edits (pre-analysis rules for medical accounts in the management system) enabled for your profile, and provide support to Accredited Providers regarding account/appeal processes and other related matters when necessary.

Junior Medical Accounts Analyst – Affirmative Action Vacancy (PCD)

• Analyze hospital medical accounts, disputes, denial appeals submitted by Providers, reimbursements submitted by beneficiaries and the Unimed system, and arrange the corresponding payments, releasing the payment process to the finance department while working under guidance.
• Verify that accounts meet regulatory requirements and comply with applicable rules by performing checklists in the system and analyses, reconciling and verifying amounts according to reference tables, and taking corrective actions when necessary.
• Monitor and propose changes, solutions and/or adjustments to workflows, the MIN (Manual de Intercâmbio) rules, ANS – National Supplementary Health Agency guidelines, and client portfolio invoices to improve daily processes.
• Manage the recording of deliberations/assessments of processes, correctly enter justifications for decisions, and check billing deadlines and the existence of signatures on deliberations generated by other areas.
• Enter and analyze provider service data and information in the system, notify any contractual modifications or system changes that allow closure of billing analyses with accuracy, and ensure payment is arranged.
• Receive, spreadsheet and file medical service invoices, generate analytical reports, and analyze denial appeals and medical accounts.
• Assess requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities related to acceptance and payment criteria for Unimeds, Providers and companies.
• Analyze and release the "malhas" (pre-analysis rules for medical accounts in the management system) enabled for your profile, and provide support to Accredited Providers regarding Account/Appeal processes and other related matters when necessary.

Medical Accounts Analyst – Junior

• Develop and apply stochastic and deterministic models to calculate provisions (IBNR, PEONA, PIC), using methods such as Chain Ladder, Bornhuetter-Ferguson and Cape Cod.
• Perform consistency (run-off) tests to validate the adherence and accuracy of past estimates.
• Ensure compliance with ANS requirements, with a strong focus on RN 442 and its successors.
• Work with a critical, auditable approach, ensuring the integrity and governance of databases.

Capital and Provisions Analyst (Mid-level)

• Ensure that documented information (policies, management guidelines, work instructions, etc.) required by the integrated management system is appropriate and sufficient for employee use and for supporting decision-making.
• Critically analyze the monitoring and measurement results of tactical and operational indicators to evaluate the performance and effectiveness of the integrated management system.
• Conduct internal audits to ensure the integrated management system is implemented effectively, based on the requirements of certifiable standards ISO 9001, ISO 27001, ISO 27701 and RN 507, as well as the organization’s own requirements.
• Attend external audits of the integrated management system (certification and maintenance) to support business areas in presenting evidence of the organization’s compliance with its certifications.
• Hold recurring alignment meetings with business areas as change agents to assess the adequacy and sufficiency of compliance evidence for maintaining the organization’s certifications and to prepare stakeholders for internal and external audits.
• Organize and lead quality forums with superintendents, managers and quality champions to promote awareness of how their actions contribute to the effectiveness of the integrated management system, including the benefits of improved performance and the implications of nonconformity with organizational and certification requirements.
• Critically evaluate the effectiveness of actions resulting from nonconformities and opportunities for improvement related to internal and external audits, indicator measurement, process execution, customer complaints, and other sources.
• Act as a quality ambassador to disseminate best management practices and process improvements in order to develop team members.
• Perform other activities inherent to the role or assigned by the immediate supervisor, provided the individual is qualified and the tasks align with their knowledge and experience.

Quality Analyst – Mid-level

• Perform lower-complexity activities to develop programs focused on health promotion and chronic disease prevention, monitoring and guiding teams in program implementation, as well as conducting and managing specific health programs such as Idoso Bem Cuidado, Oncorede, etc., working under supervision.
• Conduct research to identify at-risk individuals, performing studies and analyses aimed at preventing and reducing risks and costs for the organization.
• Support the development of instructional materials based on content produced by the area, aiming to raise awareness and promote actions for patients with chronic diseases.
• Provide support for validation of technical materials, working under supervision.
• Provide support to the commercial area with indicators for client companies.
• Assist in managing the indicators involved in different programs, compiling financial information, tracking work progress and results achieved, identifying deviations and actions to improve the programs.

Junior Comprehensive Health Care Analyst

General Counsel

• Case Management: Monitor legal proceedings in civil, regulatory and administrative arenas.
• Strategic Liaison: Manage and directly oversee matters handled by partner (external) law firms.
• Strategy Development: Assist in the execution of the company’s litigation and regulatory strategies.
• Institutional Engagement: Handle procedural communications and interactions with judges, appellate judges, judicial bodies and related entities.
• Advisory Support: Draft legal opinions, technical notes, reports and legal materials to support internal areas.
• Risk Analysis: Identify and monitor legal and regulatory risks, coordinating responses with regulatory authorities.
• Metrics and Governance: Support the update of legal indicators (KPIs), internal controls and improvements to operational workflows.
• National Reporting: Report activities and strategic matters directly to the head office in São Paulo.

Mid-level Attorney

• Guide and carry out low-, medium- and high-complexity activities to develop programs focused on health promotion and disease prevention.
• Monitor and guide teams in the implementation of programs.
• Conduct research to identify individuals at risk.
• Perform studies and analyses aimed at preventing and reducing risks and costs for the organization.
• Prepare and produce management reports, including analysis of providers and claims, and tracking and interpreting key metrics.
• Provide support to the commercial team with indicators for client companies.
• Comply with internal regulations and the requirements of quality management systems.

Senior Comprehensive Health Care Analyst

• Develop and maintain dashboards and performance indicator panels (Power BI, Tableau) that facilitate understanding of the company’s performance.
• Write SQL queries to extract data from various sources and fulfill ad-hoc requests from managers.
• Collect and clean datasets, removing duplicates and correcting errors to ensure data integrity.
• Keep the data dictionary up to date, ensuring alignment of concepts and metrics across business areas.
• Ensure rigorous data cleansing to prevent incorrect information from biasing result interpretation.

Management Information Analyst

• Ensure full availability and operational safety of building infrastructure and medical and hospital technologies.
• Ensure a risk-free physical environment and the full operation of critical life-support systems, in full compliance with applicable regulatory standards.
• Ensure activities are carried out with the least possible impact on patient care and operations.
• Maintain strict adherence between planned vs. actual schedules.
• Keep performance indicators (KPIs) up to date for decision-making.
• Measure cost savings generated by the direct activities of clinical engineering and maintenance.
• Monitor requested vs. fulfilled volumes, backlog, and status of strategic equipment.
• Control Average Response Time and the closure of Work Orders (WOs).
• Data intelligence: consolidation of system data to produce complex management reports.

Infrastructure Analyst

Systems Engineer

• Provide technical support for corporate systems, applications, and basic software, resolving low- and medium-complexity incidents and requests, with guidance when necessary.
• Log, track, and update tickets, ensuring responses within agreed deadlines and continuity of business area processes.
• Act as the initial point of contact between user areas and the technical team or IT vendors.
• Support elicitation and documentation of business needs, contributing to translating requests into functional requirements.
• Monitor the progress of requests and deliveries, supporting deadline tracking and alignment between stakeholders.
• Support the implementation and follow-up of low-effort improvements with IT vendors and internal teams.
• Verify that solutions align with CNU business rules and applicable regulatory guidelines.
• Assist in creating and executing functional tests, validating whether deliveries meet defined requirements.
• Participate in the solution deployment process and provide initial post-go-live support, assisting users and involved areas.

Junior Systems Analyst, Support

Data Analyst

• Develop, maintain, and enhance management dashboards and KPI panels using Business Intelligence tools, ensuring clarity, consistency, and reliability of the information presented.
• Extract, consolidate, and analyze data from various corporate data sources, using SQL to support recurring and ad-hoc requests from business areas.
• Execute data cleaning, validation, and transformation processes, ensuring the integrity, accuracy, and standardization of information used in reports and analyses.
• Maintain and update the corporate data dictionary, ensuring conceptual alignment of metrics, indicators, and definitions across different company areas.
• Monitor operational and strategic indicators, identifying deviations, significant variations, and opportunities for improvement, with structured reporting to requesting teams.
• Collaborate closely with the actuarial team and other business areas, supporting data interpretation and contributing to decision-making based on reliable information.