Role Description At UST, we help the world’s best organizations grow and succeed through transformation. Bringing together the right talent, tools, and ideas, we work with our client to co-create lasting change. Together, with over 30,000 employees in 30+ countries, we build for boundless impact—touching billions of lives in the process. Visit us at .

Summary: UST is looking for….

PDM Team Lead Role Summary The Provider Data Management (PDM) Team Lead is responsible for end-to-end operational leadership of provider data maintenance services. The role oversees provider outreach verification, returned mail, credentialing record updates, and PIMS claim support while ensuring accurate provider records, inventory control, quality governance, stakeholder communication, and adherence to service levels and approved Premera processes and procedures.

Key Responsibilities Operations Management

- 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 according to approved procedures.
- Maintain backup and replacement coverage to support continuity of service. Functional & Escalation Oversight
- Serve as the first point of escalation for complex provider data cases, missing information, provider discrepancies, and workflow exceptions.
- Guide the team on provider demographic, specialty, affiliation, practice location, address, credentialing, and claims-related provider record updates.
- Coordinate provider outreach by email or telephone when verification is required.
- Oversee resolution of PIMS claims where missing group or practitioner data must be loaded to support claims processing. Quality, Compliance & Governance
- Drive first-time-right processing and adherence to provider data validation controls.
- Lead calibration, defect review, root cause analysis, corrective action, and defect prevention activities.
- Ensure correspondence and supporting evidence are retained for audit readiness.
- Monitor risks involving expirable credentials, returned mail,



unresolved verification, and compliance gaps. Stakeholder Management & Reporting
- Partner with Premera operations leads, SMEs, QA, credentialing, claims, compliance, and training teams.
- Prepare weekly operational status reporting covering delivery, inventory, production, issues, risks, decisions, and support required.
- Support monthly service performance reporting, governance reviews, and change control activities.
- Recommend process improvements, documentation updates, and automation opportunities. People Leadership
- Coach PDM analysts and QA analysts on process knowledge, judgment, documentation, and performance expectations.
- Support new-hire readiness, cross-training, refresher training, and knowledge transfer.
- Promote consistent application of procedures across high-volume provider data workflows. Mandatory Skills & Competencies
- Robust knowledge of US healthcare payer provider data management and credentialing operations.
- Working knowledge of provider outreach, returned mail, credentialing record maintenance, and PIMS claim workflows.
- Understanding of provider demographics, specialties, affiliations, practice locations, NPI data, licenses, sanctions, and network records.
- Strong inventory management, people leadership, escalation management, and stakeholder communication skills.
- Ability to interpret operational reports, identify risk, and lead corrective actions. Qualifications Education
- Bachelor's degree in Healthcare Administration, Business, Life Sciences, or a related field. Experience
- 7+ years in US healthcare payer provider data management, credentialing, or provider operations.
- Minimum 2+ years in a team lead, SME, or supervisory capacity.
- Experience working in SLA-driven, high-volume operations. Preferred Tools & Systems




- Provider information management and payer administration systems.
- CAQH, NPPES, OIG, NPDB, state licensing sources, and Microsoft Excel, as applicable to assigned work. Key Performance Indicators (KPIs)
- Processing accuracy and first-pass quality
- Audit accuracy
- SLA and turnaround-time adherence
- Inventory aging and backlog reduction
- Productivity attainment
- Defect leakage and repeat-error reduction
- Timeliness and accuracy of management reporting

What You Need: BTech/ MCA/ BCA/Msc IT/Bsc IT Required Skills: Provider Credentialing, Microsoft Excel, NPPES, CAQH

What You Need: What we believe : We’re proud to embrace the same values that have shaped UST since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity.

And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion and to place people at the centre of everything we do. Humility: We will listen, learn, be empathetic and help selflessly in our interactions with everyone.

Humanity: Through business, we will better the lives of those less fortunate than ourselves. Integrity: We honour our commitments and act with responsibility in all our relationships.

Equal Employment Opportunity Statement UST is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion, or sexual orientation.

All employment decisions shall be made without regard to age, race, creed, colour, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. UST reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

- To support and promote the values of UST.
- Comply with all Company policies and procedures

Skills Provider Credentialing, Microsoft Excel, NPPES, CAQH

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