Provider Data Operations Lead—Credentialing & BPM

UST; Taguig; On-site; PHP 1,200,000 - 2,000,000; Full time

Job summary

UST is seeking a Provider Data Management Team Lead to oversee end-to-end provider data maintenance within a BPM environment. The role drives outreach verification, credentialing updates, and PIMS claim support while ensuring data accuracy, inventory control, and governance across workflows.

The candidate will lead a team, manage escalations, and coordinate cross-functional stakeholders to sustain service levels and continuous improvement in a high-volume setting.

Qualifications

• 7+ years in US healthcare payer provider data management, credentialing, or provider operations.
• Experience in SLA-driven, high-volume BPM operations.
• Experience supervising teams and driving process improvement.

Responsibilities

• Own daily PDM delivery across outreach verification, returned mail, credentialing record updates, and PIMS claim support.
• Manage work allocation, queue balancing, inventory aging, productivity, and staffing coverage.
• Ensure provider update requests are reviewed, validated, documented, and completed per procedures.
• Maintain backup coverage to support continuity of service.
• Monitor KPIs, productivity, quality metrics, and SLA adherence within BPM delivery.

Skills

Payer data management

Credentialing operations

Provider outreach & verification

People leadership

BPM governance & SLAs

Quality management

Education

Bachelor's degree in Healthcare Administration/Business/Life Sciences

Tools

PIMS workflows

BPM software

Job description

UST is seeking a Provider Data Management Team Lead to oversee end-to-end provider data maintenance within a BPM environment. The role drives outreach verification, credentialing updates, and PIMS claim support while ensuring data accuracy, inventory control, and governance across workflows.

The candidate will lead a team, manage escalations, and coordinate cross-functional stakeholders to sustain service levels and continuous improvement in a high-volume setting.