01 Jul 2024 – Aug 2026
VillageCare
Credentialing & Compliance Analyst — Provider Operations, Enrollment & Systems
New York, NY
Owned provider lifecycle work across credentialing, enrollment, sanctions screening, directory accuracy, and committee readiness — then started designing systems to make those workflows less fragile.
Scope
- Supported provider compliance and credentialing operations across a 40,000+ provider network, with direct lifecycle ownership spanning 100+ physicians and 40+ facilities per committee cycle.
- Credentialing and recredentialing, primary source verification, payor enrollment, provider activation, and directory / data maintenance.
- Sanctions and exclusions screening (OIG LEIE, SAM.gov, NYS OMIG, CMS Preclusion-related workflows) with identity-level evidence review rather than name-match assumptions.
- Credentialing committee and medical director review packages; audit-ready provider files; delegated credentialing/compliance oversight.
- Liaison across credentialing, contracting, compliance, legal, payors, engineering/IT, leadership, and providers.
Impact
- Remediated a 2,000+ provider backlog through structured tracking, escalation, outreach, and data cleanup.
- Improved credentialing turnaround time by 25% and reduced first-submission errors by 12%.
- Designed a 30+ point credentialing quality checklist and authored 8 standardized SOPs.
- Improved documentation retrieval efficiency by up to 60% in a described workflow.
- Produced 75+ monthly provider welcome / activation communications in one workflow.
- Partnered with Engineering/IT on Verisys V12 issues and provider-data integrity; identified automation opportunities across repetitive credentialing workflows.
Systems
- Salesforce / Verisys V12
- Facets
- Cactus
- CAQH
- PECOS
- NPPES
- SharePoint
- Excel
- PolicyStat
02 Jun 2023 – Dec 2023
MetroPlus Health
Regulatory Compliance & Provider Network Specialist Intern
New York, NY
Payer-side foundation: Medicare/Medicaid provider-network compliance, contract tracking, and turning regulation into operational guidance.
Scope
- Supported operations and compliance for a 1,000+ provider Medicare/Medicaid network.
- Provider network compliance, eligibility verification, credential verification, and exclusion monitoring.
- Translated CMS, DOH, Medicaid Managed Care, and Medicare Advantage requirements into SOPs, compliance matrices, and operational guidance.
Impact
- Built a Tableau-based provider compliance / contract tracker covering 250+ provider contracts.
- Improved workflow visibility and efficiency by approximately 20%.
- Reduced described eligibility determination errors by 15%.
- Conducted sanctions/exclusion monitoring across OIG, SAM.gov, and NYS OMIG.
Systems
- Tableau
- Excel
- OIG LEIE
- SAM.gov
- NYS OMIG
03 Nov 2022 – May 2023
New York University
Insurance & Risk Management Operations Assistant
New York, NY
Institutional insurance and claims operations: documentation architecture, data quality, and audit readiness at scale.
Scope
- Insurance and risk documentation, claims records, data organization, and institutional compliance support.
Impact
- Built and organized a centralized online documentation system for 5,000+ insurance/claims records spanning approximately 2000–2022.
- Improved audit/record retrieval efficiency by approximately 60%.
Systems
- Documentation systems
- Excel
- Records management
04 Apr 2021 – Aug 2021
Jupiter Lifeline Hospitals
Compliance & Quality Intern
Thane, India
Where clinician credentialing, hospital quality, accreditation, and compliance first appeared together in the work.
Scope
- NABH accreditation support, quality audits, regulatory documentation, and SOP review/mapping in a 350-bed hospital.
- Clinician onboarding and credentialing documentation; patient-safety KPI reporting.
Impact
- Mapped 30+ hospital SOPs against NABH / JCI standards.
- Built KPI dashboards tracking 50+ patient-safety metrics and reduced reporting lag by approximately 40%.
- Assisted credentialing/onboarding documentation for 60+ clinicians.
Systems
- Quality dashboards
- SOP libraries
- Accreditation documentation
05 Nov 2017 – Mar 2020
DY Patil University Hospital
Operations & Compliance Trainee
Navi Mumbai, India
Earliest practical healthcare-operations experience — hospital administration, compliance, billing coordination, and departmental workflow.
Scope
- Hospital operations, compliance, billing/insurance coordination, records, and patient-flow work across 10+ departments.
Impact
- Approximately 20% improvement in clerical-error and throughput-related friction after process work.
- Approximately 15% faster claims-processing workflow after documentation and process improvements.
Systems
- Hospital operations systems
- Billing / insurance coordination