Health Plan Assistant (Accreditation) | Health Plan Operator

Description

Job Summary: Professional to handle provider re-contracting, contract drafting, relationship management with the accredited network, and critical analysis of market fee schedules. Key Highlights: 1. Experience in relationship management with the Accredited Network 2. Knowledge of market fee schedules (CBHPM, TUSS, AMB, SIMPRO, Brasíndice) 3. Knowledge of ANS legislation and regulatory guidelines Employment Type: **Fixed-term CLT Contract.** **General Job Responsibilities:** * Provider re-contracting; * Drafting contracts and addenda; * Verification/validation of provider documentation; * Parameterization of negotiations in the system; * Monitoring of contract and term processes; * Database updates (clinical staff, address, phone number, bank details, INSS, and others); * Cross-checking between the accredited network and health plan products; * Provider relationship management; * Critical analysis of the formatting of daily rate and fee schedules. **Requirements:** * Currently pursuing a Bachelor’s degree — from the 3rd semester onward (field of study open); * Experience in relationship management with the Accredited Network (health plan operators, clinics, and hospitals); * Familiarity with XML files; * Practical knowledge of market fee schedules, including **CBHPM, TUSS, AMB, SIMPRO, and Brasíndice**; * **Intermediate-level** proficiency in Microsoft Office, especially **Excel**; * Experience in accreditation functions and provider relationship management; * Knowledge of ANS legislation and regulatory guidelines, including **RN 503, RN 566, RN 395, and the SAC Law**. **Desirable Qualifications:** * Familiarity with the **Facplan system** and **CRM** will be an advantage. **Specific Skills:** * Analytical and critical thinking; * Communication; * Emotional intelligence; * Operationalization of routine tasks; * Interpersonal relationship skills; * Critical thinking; * Systems thinking; * Strong interpersonal communication. **Expected Attitudes:** * Commitment / Responsibility; * Organization; * Teamwork; * Interpersonal relationship skills. **Working Hours:** Monday to Friday, from 8:30 AM to 5:30 PM. (On-site) **Work Location:** Asa Sul \- Brasília/DF