Provider Data Management Lead — BPM Operations

UST USource; Pateros; On-site; PHP 5,653,000 - 9,422,000; Full time

Job summary

UST USource is seeking a Team Lead for Provider Data Management (PDM) to oversee end-to-end data maintenance services within a BPM environment. You will lead outreach verification, returned mail resolution, credentialing updates, and PIMS claim support while ensuring data accuracy, governance, and SLA adherence.

The role requires strong leadership, process improvement mindset, and collaboration with cross-functional teams to drive continuous improvement in provider data workflows.

Qualifications

• Must have hands-on knowledge of US healthcare payer provider data management and credentialing operations.
• Experience with provider outreach, returned mail, credentialing maintenance, and PIMS claim workflows.
• Familiarity with BPM operations, SLA management, and quality governance.

Responsibilities

• Own daily Provider Data Management (PDM) delivery across outreach verification, returned mail, credentialing updates, and PIMS claim support.
• Manage work allocation, queue balancing, inventory aging, productivity, and staffing coverage.
• Ensure updates are reviewed, validated, documented, and completed per procedures; maintain backup coverage for continuity.
• Monitor KPIs, quality metrics, and SLA adherence within BPM delivery model.
• Serve as escalation point for complex provider data cases and workflow exceptions.

Skills

Provider data management

Credentialing operations

SLA management

Team leadership

Process governance

Stakeholder communication

Education

Bachelor's degree in Healthcare Administration / related field

Job description

UST USource is seeking a Team Lead for Provider Data Management (PDM) to oversee end-to-end data maintenance services within a BPM environment. You will lead outreach verification, returned mail resolution, credentialing updates, and PIMS claim support while ensuring data accuracy, governance, and SLA adherence.

The role requires strong leadership, process improvement mindset, and collaboration with cross-functional teams to drive continuous improvement in provider data workflows.