Lead II - BPM-BPM Configuration Lead

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 Configuration Lead 8+ years of Healthcare Payer and BPM experience with strong understanding of Claims, Enrollment, Billing, Provider, and Benefit Administration processes. Hands-on TriZetto FACETS Configuration experience, including Product Configuration, Group Setup, Benefits Configuration, and Claims Adjudication Rules. Proven experience configuring: Product Shells Finals Benefit Plans BQT Templates Deductibles, Copays, Coinsurance Network and Service Payment Rules Group, Subgroup, Class Plan, and Billing Structures. Strong knowledge of FACETS Claims Processing, Benefit Interpretation, and Configuration-driven Adjudication. Experience leading Configuration Analysts and cross-functional teams, including work planning, mentoring, reviews, and stakeholder management. Experience working in Healthcare BPM/BPO environments, supporting operational excellence, process governance, SLA adherence, and continuous improvement initiatives. Working knowledge of Healthcare EDI transactions (834/837), SQL, ServiceNow, Azure DevOps, and configuration migration processes. Strong understanding of HIPAA, healthcare compliance, audit controls, and quality standards. Excellent communication and stakeholder management skills with the ability to translate business requirements into FACETS configuration solutions. Preferred: FACETS Certification and prior experience supporting large-scale healthcare payer implementations and transformations. Experience in Healthcare BPM operations and process transformation initiatives is highly preferred.

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, its 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

SQL, FACETS, ServiceNow, HIPAA