Healthcare Provider Data Lead — BPM Operations

UST; Taguig; Hybrid; PHP 900,000 - 1,500,000; Full time

Job summary

UST in the Philippines is seeking a Team Lead for Provider Data Management to oversee end-to-end data maintenance services within a BPM environment. The role coordinates outreach verification, returned mail, credentialing record updates, and PIMS claim support, ensuring accurate provider records and adherence to SLA.

You will manage staff, monitor KPIs, drive process improvements, and communicate with cross-functional stakeholders to sustain audit readiness and quality governance across the

Qualifications

• Experience in US healthcare payer data management and credentialing.
• Familiarity with provider demographics, NPIs, licenses, sanctions, and network records.
• Experience leading teams in SLA-driven, high-volume BPM operations.
• Ability to interpret operational reports, identify risks, and drive corrective actions.
• Strong governance, audit readiness, and quality management practices.

Responsibilities

• Own daily PDM delivery across outreach verification, returned mail, credentialing updates, and PIMS support.
• Manage workload balancing, inventory aging, productivity, and staffing coverage.
• Ensure provider update requests are validated, documented, and completed per procedures.
• Maintain backup coverage to support continuity of service and SLA adherence.
• Lead calibration, root-cause analysis, corrective actions, and defect prevention.

Skills

Provider data management

Credentialing operations

PIMS claim workflows

SLA management

BPM governance

Leadership

Stakeholder communication

Quality assurance

Process improvement

Data quality monitoring

Education

Bachelor's degree in Healthcare Administration or related field

Job description

UST in the Philippines is seeking a Team Lead for Provider Data Management to oversee end-to-end data maintenance services within a BPM environment. The role coordinates outreach verification, returned mail, credentialing record updates, and PIMS claim support, ensuring accurate provider records and adherence to SLA.

You will manage staff, monitor KPIs, drive process improvements, and communicate with cross-functional stakeholders to sustain audit readiness and quality governance across the