Senior Healthcare Payer Operations Lead

UST; Philippines; On-site; PHP 1,200,000 - 1,600,000; Full time

Job summary

UST is seeking a Healthcare Operations Sr. Manager to lead end-to-end service delivery for payer BPO workstreams in the Philippines.

You will manage multi-functional teams across Claims, Enrollment & Billing, Provider Operations, and Contact Center to meet SLAs, quality, and transformation goals. The ideal candidate brings deep US healthcare domain expertise, a track record of scaling high-performance delivery models, and hands-on leadership in operations.

Qualifications

• 12+ years in Healthcare BPO / Payer Operations.
• 5+ years in operations leadership / delivery management.
• Understanding US payer operations including claims, provider data, enrollment and billing.

Responsibilities

• Own end-to-end service delivery across Claims, Enrollment & Billing, PDM, and Contact Center aligned to SLAs.
• Drive governance, reporting, RCA discussions, and cost/productivity benchmarks.
• Lead process transformation using Lean, Six Sigma, and automation; identify AI/automation opportunities.
• Ensure HIPAA/compliance, audit readiness, and risk mitigation across geographies.

Skills

Delivery leadership

Stakeholder management

Data-driven decisions

SLA/KPI management

Lean Six Sigma

Healthcare payer ops

Facets knowledge

Payer operations

Tools

Facets platform

Job description

UST is seeking a Healthcare Operations Sr. Manager to lead end-to-end service delivery for payer BPO workstreams in the Philippines.

You will manage multi-functional teams across Claims, Enrollment & Billing, Provider Operations, and Contact Center to meet SLAs, quality, and transformation goals. The ideal candidate brings deep US healthcare domain expertise, a track record of scaling high-performance delivery models, and hands-on leadership in operations.