Business Rules Analyst II

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🕒 June 8

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Unimed

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

👥 B2C

Healthcare Insurance • B2C

Unimed is a Brazil-based cooperative healthcare system that operates hospitals, clinics and a large network of medical providers while offering health insurance plans and related services to individuals and organizations. It provides doctor and facility directories, hospital services, plan management (billing, plan searches), occupational health services, health education and sustainability and governance resources across regional Unimed cooperatives.

📋 Description

• Analyze, design, implement and evolve business rules and parameters, considering system-wide impacts on healthcare provision, care costs, customer experience, regulatory compliance and financial sustainability; • Work in a matrix structure, identifying opportunities and criticalities for creation, review or removal of rules, with an integrated view across contracts, coverages, provider network, audits, regulation and care models; • Lead the implementation, maintenance and testing of parameters and business rules in corporate systems, ensuring consistency, traceability, evidence generation and correct operational applicability; • Develop and implement mechanisms to automate rules and parameters, reducing manual interventions, operational risks, waste and systemic inconsistencies; • Implement systemic metrics, alerts and controls to signal risks, nonconformities and care deviations, supporting active cost management and data-driven decision-making; • Create, monitor and analyze indicators related to the effectiveness of rules and parameters, acting proactively on deviations, application failures or improvement opportunities; • Evaluate requests from internal areas, performing critical analysis, prioritization, technical alignment and, when necessary, coordination with IT and business areas to enable solutions; • Work with IT to validate new system versions, enhancements and fixes, including executing consistency tests, approvals and monitoring of deliveries; • Ensure correct implementation of rules related to current legislation (ANS, TISS, List of Procedures, contracts, waiting periods, copayments and negotiations), mitigating regulatory and litigation risks; • Support the design and enablement of new business models, assessing impacts and needs for new types of parameterization and automation; • Provide technical support to internal areas, the Provider Network and Unimeds, advising on rules, parameters and best practices, acting as a facilitator of integrated solutions; • Provide leadership, managers and executives with technical analyses and strategic information related to rules, parameters, contracts and care processes; • Contribute to area governance through monitoring indicators, participating in or leading internal and external meetings and supporting strategic projects; • Keep tables, parameters and reference databases up to date in accordance with Unimed do Brasil guidelines, negotiations, the List of Procedures and regulatory standards; • Promote knowledge dissemination and strengthen organizational maturity regarding rules and parameters; • Support area management in planning, budget control, SOP revision and other administrative routines related to team operations.

🎯 Requirements

• Completed higher education (Bachelor's degree or equivalent).

🏖️ Benefits

• Position also open to candidates with disabilities.