Alisha Kunte

About

I work on the systems that decide whether a provider can actually enter a network.

Credentialing, enrollment, sanctions, provider data, and the workflows connecting them — then the software that could make those workflows less fragile.

Alisha Kunte, healthcare operations professional
Alisha Kunte

01

Hospital operations, first

I studied hospital and healthcare administration from undergraduate through an MBA, then worked inside hospital operations, quality, and accreditation in India. Credentialing, SOPs, and compliance were not an accidental later chapter — they were already the work.

02

Quality, accreditation, clinicians

At Jupiter Lifeline Hospitals I mapped SOPs against NABH and JCI standards, reported patient-safety KPIs, and supported clinician onboarding documentation. That is where provider files, quality, and regulation started to look like one system.

03

NYU, policy and management

An MPH in Healthcare Policy & Management at NYU School of Global Public Health (GPA 3.8) added regulation, health systems, analytics, and the payer/provider context around the hospital work I already knew.

04

Payer networks at MetroPlus

A compliance and provider-network internship at MetroPlus put me on the payer side of Medicare and Medicaid: contracts, eligibility, exclusion monitoring, and the problem of seeing 250+ agreements in one place. I built a Tableau tracker so the work was visible.

05

Provider lifecycle at VillageCare

As a Credentialing & Compliance Analyst I worked the operational chain most patients never see: credentialing, enrollment, sanctions, directory accuracy, committee packages, and payer coordination — supporting a 40,000+ provider network, with direct lifecycle ownership spanning 100+ physicians and 40+ facilities per committee cycle.

06

The same provider, disagreeing systems

The recurring failure mode was fragmentation. One provider can exist in NPPES, CAQH, PECOS, licensing boards, sanctions databases, payer systems, and internal records — and those systems do not always agree. Backlogs and rework were often data and workflow design problems wearing an operations costume.

07

From operating the workflow to building it

I started building the tooling I wished existed: first a Salesforce proof of concept with Apex and a live NPPES check, then a standalone provider-operations platform. The through-line is the same: verified source data, deterministic rules, ordered next actions — and AI only after the facts are in.

Education

Healthcare administration, continuously.

  • Sep 2022 – May 2024

    New York University

    School of Global Public Health

    Master of Public Health (MPH), Healthcare Policy & Management

    New York, NY

    GPA 3.8 / 4.0

    Healthcare policy, management, regulation, health systems, analytics, and operations.

  • Aug 2020 – Jul 2022

    IIHMR University

    MBA, Hospital & Healthcare Administration

    Jaipur, India

    Hospital administration, healthcare management, quality, operations, and healthcare systems.

  • Aug 2017 – May 2020

    DY Patil University

    BBA, Hospital & Healthcare Administration

    Navi Mumbai, India

    Undergraduate foundation in hospital and healthcare administration — the start of a continuous healthcare-operations path.

Expertise

Four domains.

Technical toolkit spanning SQL, Python, Salesforce Flow/Apex, analytics, and workflow automation, with active hands-on portfolio development in healthcare operations systems.

Provider Operations

  • Credentialing & recredentialing
  • Payor enrollment
  • Provider networks & directories
  • Affiliations, groups & entity structures

Compliance

  • OIG LEIE, SAM.gov, NYS OMIG
  • CMS & NYS DOH operations
  • NCQA credentialing concepts
  • Medicare / Medicaid managed care

Systems & Data

  • Salesforce / Verisys, Facets, Cactus
  • NPPES, CAQH, PECOS
  • SQL, Tableau, Power BI, Excel
  • Provider data integrity

Automation

  • Apex & Salesforce Flow
  • Python & REST APIs
  • Deterministic rules engines
  • AI-assisted case summaries

Languages

  • EnglishFluent
  • HindiFluent
  • MarathiFluent
  • SpanishWorking proficiency

Contact

For provider operations, network, and healthcare systems roles.

I am most useful where credentialing, enrollment, compliance, provider data, and workflow design meet — and where those workflows need to become systems.

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