Healthcare Utilization Review Nurse

Job not on LinkedIn

🔥 16 hours ago

🇧🇷 Brazil – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Grupo Fácil

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1996

🏥 Healthcare

💸 Finance

💳 Fintech

Healthcare • Finance • Fintech

Grupo Fácil is a national reference in technology and solutions for the Healthcare and Financial institutions sectors, with over 29 years of experience. The group is composed of several companies that excel in customer service and technical excellence, focusing on delivering surprising results and being closely connected to market trends. Grupo Fácil prides itself on its solidity and boldness in undertaking projects that set a benchmark in the industry.

📋 Description

• Review medical authorization requests and issue favorable or unfavorable determinations within the scope of technical expertise • Route requests for specialized review based on the needs and expertise required • Assist and support the administrative team by providing guidance on requests and workflows • Communicate observations, recommendations, and technical conclusions in writing to the responsible parties • Participate in team meetings, contributing to alignment and process improvement • Take a strategic approach to analyzing and directing care-related demands • Ensure compliance, quality, and safety across healthcare utilization management processes

🎯 Requirements

• Bachelor’s degree in Nursing • Active and unrestricted registration with the Regional Nursing Council (COREN), accompanied by a Certificate of Ethical Standing • Practical knowledge of Microsoft Office tools (Excel, Word, and PowerPoint) • Excellent verbal and written communication skills for preparing clinical opinions and guidance • Strong sense of urgency, objectivity, and strict procedural discipline when handling requests • Continuous-improvement mindset, with an interest in acquiring new knowledge and training • Previous experience in healthcare utilization management, health insurance companies, or hospital settings • Solid knowledge of regulations and guidelines issued by the Brazilian National Supplementary Health Agency (ANS) • Extensive experience working with multidisciplinary teams • Postgraduate qualification in Nursing Audit, Healthcare Management, or a related field is desirable

🏖️ Benefits

• Opportunity to be hired as an independent contractor or under an employment contract • Affirmative opportunity for LGBTQIA+ individuals • Affirmative opportunity for women • Affirmative opportunity for Indigenous people • Affirmative opportunity for Black people • Affirmative opportunity for people aged 40 and over • Remote work