ak.

Healthcare Operations | Provider Data | Compliance

Alisha Kunte, MPH

I work across healthcare operations, provider data, and compliance, translating complex requirements into workflows teams can use.

View my workDownload resume

alishakunte6@gmail.comLinkedIn

Experience and impact

Credentialing, enrollment, provider data, and compliance work.

Roles at VillageCareMAX, MetroPlusHealth, and in hospital operations, with a focus on credentialing, enrollment, provider data quality, compliance, and process improvement.

Jul 2024 – Aug 2026

VillageCareMAX

Credentialing & Compliance Analyst

  • • Supported credentialing, enrollment, and provider-data operations across a 40,000+ provider network, with lifecycle work spanning committee cycles for physicians and facilities.
  • • Remediated a 2,000+ provider backlog and improved credentialing turnaround time by 25% through structured tracking, outreach, and process cleanup.
  • • Wrote 8 SOPs and a 30+ point quality checklist, and screened providers against OIG LEIE, SAM.gov, and NYS OMIG.

Jun 2023 – Dec 2023

MetroPlusHealth

Regulatory Compliance & Provider Network Specialist Intern

  • • Supported compliance operations for a 1,000+ provider Medicare and Medicaid network.
  • • Built a Tableau tracker covering 250+ provider contracts so enrollment and participation status were easier to see.
  • • Monitored exclusions across OIG LEIE, SAM.gov, and NYS OMIG and translated regulatory requirements into operational guidance.

Apr 2021 – Aug 2021

Jupiter Lifeline Hospitals

Compliance & Quality Intern — hospital operations

  • • Mapped 30+ hospital SOPs against NABH accreditation standards as part of quality and compliance work.
  • • Assisted credentialing and onboarding documentation for 60+ clinicians.
  • • Tracked 50+ patient-safety KPIs to reduce reporting lag in hospital operations.

Featured project

Salesforce Provider Credentialing & Enrollment Ops

Verification evidence is spread across portals and spreadsheets, so teams repeat checks, lose source history, and struggle to see what is blocking a provider record.

This build connects source results, timestamps, and review actions to a provider record in Salesforce so the next action is clear.

Salesforce Provider Credentialing & Enrollment Ops

Choose a sample case, then step through verification.

Inspect the evidence at each source and see how the final outcome changes. Every payload on this page is a demonstration response.

This website demo is synthetic and simulated. It does not connect to a Salesforce org or live registries.

Check 1 of 7: Provider

Complete evidence

Provider

The synthetic provider record and the information being checked in this run.

Name
Avery Morgan, MD
NPI
1487654321
Taxonomy
207Q00000X — Family Medicine
State
New York
Group
Juniper Medical Group
Service locations
Harbor Clinic, Park Clinic

Demonstration response

Source
Internal Salesforce Provider__c record (demonstration)
Result
Synthetic record opened for verification: Avery Morgan, NPI 1487654321, Family Medicine, New York.
Captured timestamp
2026-09-13T14:00:00Z
Match basis
Selected sample case; no live org lookup
Evidence reference
DEMO-PROVIDER-AM-001

Illustrative relationships

Groups and service locations

Select a synthetic provider, provider group, or service location to see how it connects. These affiliations are illustrative relationships, not a live practice roster.

Provider details

Avery Morgan

Credential
MD
NPI
1487654321
Specialty
Family Medicine
State
New York

Avery Morgan is the synthetic practitioner at the center of this demonstration. Affiliations below are illustrative relationships, not a live practice roster.

Behind the build — architecture and source notes

This website demo is synthetic and simulated. It does not connect to a Salesforce org or live registries. These notes describe the operational design, not a live connection from this website.

Provider__c record

A Salesforce custom object holds the provider as the system of record: identity fields, NPI, specialty, check timestamps, evidence references, and risk flags. The website mirrors that shape with synthetic records only.

Flow orchestration

A record-triggered or screen Flow walks one provider through the verification sequence so an analyst can run checks without leaving Salesforce. This demo steps through the same sequence in the browser.

Apex service

An Apex service normalizes each lookup into a consistent evidence payload: source, result, timestamp, match basis, and evidence reference. In the original proof of concept, NPPES was the first live adapter.

External lookups

The operational design calls public and enrollment sources in order: NPPES for identity, NY Medicaid and CMS PECOS for enrollment, FHIR for relationship mapping, and OIG LEIE for exclusion screening. This site does not perform those calls.

Evidence storage

Each check writes a reviewable artifact onto the provider record rather than overwriting a checkbox. Source history stays attached so the next reviewer can see what was captured and when.

Risk flags

Deterministic flags set Low, Medium, or High risk and a next action: ready for analyst review, hold for enrollment review, or hold and escalate to compliance. Flags recommend a queue; they do not approve credentialing.

Detailed source notes

  • NPPES

    National Plan and Provider Enumeration System. Used for legal name, NPI status, and taxonomy. The Salesforce proof of concept included a working NPPES callout. This website uses a canned demonstration response.

  • NY Medicaid

    State enrollment evidence. An unresolved match is treated as an enrollment gap and routes to enrollment review. No live Medicaid portal is queried here.

  • CMS PECOS

    Medicare enrollment evidence. Shown as a demonstration payload with an enrollment identifier. This is not a PECOS login or production extract.

  • FHIR

    Used to show how Practitioner, Organization (group), and Location (service location) records relate. Labeled as relationship mapping, not as a verification or exclusion registry.

  • OIG LEIE

    Exclusion screening. A possible name match is a review trigger, not a confirmed exclusion. The demo never labels a potential match as a verified OIG exclusion.

About

Alisha Kunte, MPH

I earned my MPH in Healthcare Policy and Management at NYU. I am interested in healthcare technology, systems implementation, and the provider infrastructure that sits behind credentialing, enrollment, and compliance.

Skills

  • Provider operations
  • Workflow improvement
  • Salesforce
  • Data quality
  • Compliance

Contact

Let’s talk about provider operations and systems work.

Email, LinkedIn, and resume are the fastest ways to reach me.