Provider Network Analyst
Unimed Nacional
full-time
Posted on:
Location Type: Hybrid
Location: Manaus • Brazil
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About the role
- Validate the application of the contractual index (IPCA) according to the conditions established in the contract, performing checks and making annotations when necessary.
- Conduct periodic visits to providers, focusing on operational contract monitoring and institutional relationship management.
- Support providers in communication with the head office, acting in situations with low resolvability to restore operational flow and the relationship.
- Collect and analyze provider performance indicators, with a focus on billing, care profile and service delivery, preparing comparisons and management input.
- Monitor network qualification according to criteria defined by the head office, ensuring adherence to mandatory regulations and internal guidelines.
- Execute the documentation process for new credentialing, ensuring registration and regulatory compliance.
- Perform systematic evaluation of new credentialing according to pre-established criteria.
- Monitor the registration progress of new providers, ensuring information is up to date and consistent.
- Verify the alignment of the new provider's profile with the conditions defined by the Interchange area, reporting deviations when identified.
- Assist providers through multiple communication channels, logging and following up on requests according to defined workflows.
Requirements
- Bachelor's degree in Administration, Healthcare Management or related fields
- Previous experience in provider network management, credentialing, negotiation or related areas within supplementary healthcare
Benefits
- Candidates with disabilities are welcome.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider network managementcredentialingperformance analysisbilling analysisservice delivery evaluationregulatory compliancedocumentation processdata comparisonoperational monitoring
Soft skills
communicationrelationship managementnegotiationproblem-solvingorganizational skills
Certifications
Bachelor's degree in AdministrationBachelor's degree in Healthcare Management