Kiara Quaye
Summary
Data Information Analyst and Credentialing Specialist with proven success in streamlining provider maintenance activities and supporting accreditation efforts. Skilled in utilizing credentialing software and databases to verify provider credentials and maintain compliance with industry regulations. Committed to enhancing operational efficiency and data integrity in healthcare administration.
Overview
18
18
years of professional experience
Work History
Provider Maintenance Specialist
LanceSoft
Manhattan, NY
05.2025 - 06.2026
- Verified provider credentials, licenses, and sanctions through NPPES and state license websites.
- Verified and ensured compliance of provider licenses prior to onboarding into the system.
- Maintained accurate provider demographic and credentialing information in Salesforce and Cactus databases.
- Created, updated, and maintained provider records in MetroPlus databases.
- Utilized Cactus, PowerStepp, Salesforce, NPPES, state license websites, and Excel to streamline provider maintenance activities.
- Entered provider information into internal systems and maintained confidential provider data accurately.
- Added provider contracts to support provider participation and servicing of members in New York hospitals.
- Supported provider maintenance and credentialing processes for healthcare organizations including Hamaspik Choice and WellCare.
Provider Relations Specialist
Hamaspik Choice, Inc.
Monsey, NY
06.2021 - 04.2025
- Identified and corrected data entry errors, preventing duplication across systems and enhancing data integrity.
- Used Salesforce as the primary database where accurate provider information regarding demographic, Par and or NonPar LOB information is kept for quick reference.
- Documented file notes clearly and concisely in Salesforce & QNXT.
- Utilized NCQA framework for provider quality, ensuring compliance with primary source verification during credentialing to support organizational accreditation and enhance care quality.
- Spearheaded projects regarding data collection and file extraction for HEDIS compliance. Ensuring members are up to date with appointments and receiving preventive care. Contacting and acting as a liaison for the health plan and providers by retrieving pertinent information from members' charts following HIPAA guidelines.
Data Analyst- Securities
Citigroup Global Services Ltd
Jersey City, NJ
01.2020 - 04.2021
- Assisted in internal and external SOC 2 audits by pulling, reviewing and organizing log data (web server, application & security logs) to verify that access controls are operating effectively.
- Monitor and analyze user access privileges to ensure data is handled securely and in accordance with compliance policies.
- Uploaded CUSIP data from closing spreadsheet into access database for accurate record-keeping.
- Utilized analytical tools to evaluate performance metrics and business processes.
- Collaborated with teams to develop reporting tools and dashboards for data visualization.
- Documented security incidents and prepared reports for management review.
- Analyzed system logs and identified potential threats or risks.
- Implemented access control measures to protect information assets.
- Managed user authentication and authorization of data access.
Network Contracting Coordinator
Centers Plan for Healthy Living
Staten Island, NY
08.2016 - 12.2019
- Drafted and negotiated amendments & addendums to physician, hospital and ancillary contracts.
- Contributed to proposal development for new business within provider network, supporting strategic growth initiatives.
- Organized and updated documentation logs for providers in contracting process, enhancing tracking and accessibility.
- Addressed provider contracting inquiries on processes, policies, procedures, and fee schedules, ensuring clarity and compliance.
- Maintained files and documentation logs for providers that are in the process of being contracted.
Procurement Analyst
Lockheed Martin
Virginia Beach, VA
01.2013 - 04.2016
- Reviewed purchase orders for accuracy and alignment with project requirements.
- Coordinated with other departments such as accounting, legal, logistics and IT to facilitate smooth procurement process.
- Provided support in resolving disputes or discrepancies between vendors and end-users regarding supply issues.
- Maintained accurate records of all procurement activities in accordance with company policies.
- Analyzed procurement data to identify cost-saving opportunities and process improvements.
Data Network Specialist
Amerigroup Corporation
Chesapeake, VA
09.2008 - 12.2012
- Assisted business analysts and PDQ department with termination of duplicate providers in Facets software, ensuring data accuracy.
- Selected and loaded provider claims from external claims database, transferring data elements to active common practitioner records and establishing definitions and storage for CLIA certifications in Facets while maintaining confidentiality.
- Ensured accurate termination of provider records in Facets to maintain data integrity.
- Assisted other departments in developing strategies for improving overall network performance.
- Worked closely with other IT staff members to ensure successful implementation of projects.
- Identified, reported and resolved network security violations.
Education
Bachelor of Science - Information Technology
Old Dominion University
Norfolk, VA, United StatesAssociate of Science - Business Administration
Tidewater Community College
Norfolk, VA, United StatesSkills
- SIEM knowledge
- SPLUNK knowledge
- Credentialing Software
- MediTract knowledge
- Elasticsearch knowledge
- SOC 1 & 2 knowledge
- Salesforce knowledge
- Cactus knowledge
- NPPES knowledge
- Facets knowledge
- HEDIS/ QARR
- Database management
- Contract negotiation
- Data Collection
- Typing: 55 WPM
- Microsoft Office suite
- Log collection
- Swift App Development Cert
Recruiter Summary
- Kiara Quaye is an experienced Data Analyst with an understanding of SIEMS in SOC1 controls and workflows workflows. Strong ability to analyze data, identify patterns, and draw logical conclusions.
- She also has extensive knowledge as a Provider Relations Specialist with experience in documenting file notes clearly and concisely in Salesforce & QNXT.
- She has experience in using NCQA as a framework and benchmark for provider quality, during the credentialing process it is imperative to be in compliance with NCQA's primary source verification practices.
- Kiara has experience in utilizing Salesforce as the primary database where accurate provider information regarding demographic information. In addition to CACTUS for Par and or non par LOB information is kept for quick reference.
- She has experience in SIEM which include monitoring alerts, investigating suspicious events and summarizing findings for escalation.
- Basic experience in Identity and Access Management.
- She has experience in conducting Access & Availability studies as needed. Experience in conducting delegated credentialing audits and on-site provider office assessments required for credentialing.
Timeline
Provider Maintenance Specialist
LanceSoft
05.2025 - 06.2026
Provider Relations Specialist
Hamaspik Choice, Inc.
06.2021 - 04.2025
Data Analyst- Securities
Citigroup Global Services Ltd
01.2020 - 04.2021
Network Contracting Coordinator
Centers Plan for Healthy Living
08.2016 - 12.2019
Procurement Analyst
Lockheed Martin
01.2013 - 04.2016
Data Network Specialist
Amerigroup Corporation
09.2008 - 12.2012
Bachelor of Science - Information Technology
Old Dominion University
Associate of Science - Business Administration
Tidewater Community College