Associate III - BPM

Who we are:

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 UST.com.

Summary:

BPM - PDM SME/Trainer Role Summary The Provider Data Management (PDM) SME/Trainer is responsible for providing subject matter expertise, training, coaching, and operational support across provider data management processes. The role supports knowledge transfer, new-hire and refresher training, complex-case resolution, process clarification, and production readiness across outreach verification, returned mail, credentialing record updates, and PIMS claim support. The SME/Trainer works closely with Operations, QA, and leadership to promote consistent process execution, maintain training effectiveness, and reinforce adherence to approved processes and procedures. Key Responsibilities Training & Knowledge Transfer Develop, maintain, and deliver training for provider data processes, including outreach verification, returned mail, credentialing record updates, and PIMS claim support. Facilitate new-hire training, process training, refresher sessions, and targeted coaching based on operational and quality needs. Translate approved policies, SOPs, job aids, and process updates into practical training content and transaction-level guidance. Conduct knowledge assessments, mock transactions, and readiness evaluations before associates transition to production. PDM Subject Matter Expertise Serve as a primary point of contact for process-related questions, complex transactions, and procedural clarifications. Provide guidance on provider demographics, addresses, specialties, affiliations, practice locations, identifiers, and supporting documentation requirements. Support interpretation of credentialing and provider data requirements, including primary-source verification and applicable compliance checks. Review complex or exception scenarios and provide guidance consistent with approved processes and escalation procedures. Credentialing & Compliance Support Provide training and SME guidance on credentialing and recredentialing record updates and associated documentation requirements. Reinforce requirements related to licensure, certification, sanctions, exclusions, primary-source verification, and other applicable checks. Educate associates on identifying missing documentation, discrepancies, red flags, and cases requiring escalation. Support operational readiness for internal, client, and regulatory audits by reinforcing documentation and process requirements. Quality, Coaching & Continuous Improvement Partner with QA and Operations to identify recurring defects, knowledge gaps, and process improvement opportunities. Conduct targeted coaching and refresher training based on audit trends, root cause analysis, process changes, and operational performance. Participate in calibration sessions to maintain consistent interpretation of policies, SOPs, and transaction requirements. Recommend updates to training materials, job aids, knowledge assessments, and preventive controls based on identified learning needs. Reporting & Operational Support Maintain training materials, knowledge assessments, training attendance, coaching records, and readiness trackers. Provide training and knowledge-gap insights to the PDM Team Lead, QA, Operations, and other stakeholders. Monitor post-training performance and support validation of training effectiveness. Provide floor support, production assistance, and complex-case guidance during transition, ramp-up, and steady-state operations. Mandatory Skills & Competencies Strong knowledge of US healthcare Provider Data Management and provider operations. Strong understanding of provider data validation, credentialing and recredentialing, primary-source verification, and compliance requirements. Familiarity with CAQH, NPPES, OIG, NPDB, state licensing sources, and payer provider records. Strong training facilitation, coaching, communication, documentation, and presentation skills. Ability to interpret SOPs and policies and translate them into clear operational guidance and training. Strong analytical and problem-solving skills with the ability to support complex provider data scenarios. Ability to identify knowledge gaps and develop targeted training or coaching interventions. Qualifications Education Bachelor's degree or equivalent relevant experience. Experience 5+ years of experience in US healthcare provider data management, credentialing, recredentialing, or provider operations. Minimum 2+ years of experience in an SME, trainer, process specialist, or coaching role. Experience delivering training and providing production support within high-volume, SLA-driven healthcare operations. Experience supporting new-hire training, knowledge transfer, nesting/ramp-up, and ongoing refresher training preferred. Preferred Tools & Systems Provider information management and payer administration systems. Learning management, training documentation, knowledge management, and reporting tools. Microsoft Excel, PowerPoint, Word, and related productivity tools. Key Performance Indicators (KPIs) Training completion rate Knowledge assessment/pass rate Training effectiveness New-hire production readiness Post-training quality performance Knowledge-gap closure Refresher/coaching effectiveness Training documentation compliance SME query resolution and turnaround Process and calibration consistency

• 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

Healthcare Systems, Microsoft Excel, Provider Credentialing, Provider Data Management