Lead I BPM- PDM

About The Job:

• The Provider Data Management (PDM) Team Lead is responsible for end-to-end operational leadership of provider data maintenance services within a Business Process Management (BPM) environment.
• 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 process compliance and adherence to service levels and approved Client processes and procedures.

Essential Job Functions:
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.
• Monitor operational KPIs productivity quality metrics and SLA adherence within the BPM delivery model.

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.
• Ensure adherence to standardized BPM workflows and operational governance practices.

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.
• Drive continuous process improvement initiatives to enhance operational efficiency quality and customer outcomes.

Stakeholder Management & Reporting

• Partner with Client 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.
• Participate in operational reviews and governance forums to ensure alignment with BPM objectives and service commitments.

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.
• Drive employee engagement capability development and performance excellence within the BPM operations team.

Qualifications:
Mandatory Skills & Competencies

• Strong 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.
• Strong understanding of BPM operations SLA management process governance quality management and continuous improvement methodologies.

Education

• Bachelors 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 BPM 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.

How to Apply: Interested candidates are encouraged to respond/submit their updated resumes and for additional job opportunities please visit Jobs In India VARITE.

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If youre not available or interested in this opportunity please pass this along to anyone in your network who might be a good fit and interested in our open positions. VARITE offers a Candidate Referral program where youll receive a one-time referral bonus based on the following scale if the preferred candidate completes a three-month assignment with VARITE.

Experience Level Bonus Referral:

• 0-2 years - INR 5000
• 2-6 years - INR 7500
• 6 years - INR 10000

About VARITE: VARITE is a global staffing and IT consulting company providing technical consulting and team augmentation services to Fortune 500 Companies in USA UK CANADA and INDIA. VARITE is currently a primary and direct vendor to the leading corporations in the verticals of Networking Cloud Infrastructure Hardware and Software Digital Marketing and Media Solutions Clinical Diagnostics Utilities Gaming and Entertainment and Financial Services.

Equal Opportunity Employer:

VARITE is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based on race color religion sex sexual orientation gender identity or expression national origin age marital status veteran status or disability status.