Operations case study · MetroPlus · 2023
Provider Contract & Compliance Tracker
A Tableau tracker across 250+ provider contracts that made Medicare/Medicaid network compliance visible as a workflow — not a quarterly scramble.
- Tableau
- Excel
- CMS / DOH requirements
01
Problem
Provider contracts, participation status, and compliance artifacts lived in files and inboxes. Network and compliance teams could not see, in one place, which of 250+ contracts were current, which needed action, and where eligibility or credential checks were stalling.
02
Why it matters in healthcare
A managed-care network is only as current as its contracts and eligibility determinations. Invisible worklists create delayed onboarding, missed monitoring, and audit risk. Visibility is an operational control, not a vanity dashboard.
03
Existing workflow
Status lived in shared spreadsheets and individual follow-ups. Leadership questions about contract coverage or delayed items required a manual rebuild of the picture each time.
04
What I designed
- A Tableau-based provider compliance / contract tracker covering 250+ contracts in a 1,000+ provider Medicare/Medicaid network.
- A view built for operators and oversight — what is open, what is late, what is complete — rather than a static report.
- Regulatory requirements translated into fields a tracker can actually enforce: SOPs and compliance matrices sitting behind the metrics.
05
Architecture
Source contract and compliance data → structured tracker → operational view of delays, eligibility issues, and follow-up. Analytics as a worklist, not a slide.
- 01Contract Files
- 02Structured Data
- 03Tableau Tracker
- 04Worklist View
- 05Follow-up
06
Data sources
Sources are labeled by access type. Restricted commercial or federal feeds are never presented as live credentials.
Live / public
- Internal contract and compliance records used in the internship
07
Rules / decision logic
The tracker surfaced status and delay; it did not auto-adjudicate contracts. Exclusion monitoring (OIG, SAM.gov, NYS OMIG) and eligibility checks remained human-owned processes, made easier to see.
08
What is live vs mocked
This was real operations work at MetroPlus Health: a Tableau tracker used in a provider-network / compliance internship. It is an analytics and workflow case study, not a software product, and not part of the later independent platform.
09
Implementation
- Tableau dashboard over structured contract/compliance data.
- Paired with SOP and compliance-matrix work so the tracker reflected regulatory requirements rather than informal status labels.
10
Screens / demo
Editorial workflow layouts — not screenshots of a claimed production product.
View 01
Contract coverage and status across 250+ records.
View 02
Delay / workflow visibility that supported an approximately 20% efficiency improvement in the described process.
View 03
No product UI to demo — the artifact is an operations tracker.
11
What I learned
- If a compliance process cannot be seen, it cannot be staffed. Trackers are part of the control environment.
- The same instinct — make fragmented provider work visible — later showed up in Salesforce automation and the standalone platform.
12
What I would build next
- The independent platform generalizes this idea: not only contract status, but verification evidence, readiness, and next actions on the provider lifecycle.