Manuel Almonte
New York
Summary
Provider Data Analyst with 11+ years overseeing large delegated networks and maintaining database accuracy for 9,000–10,000+ providers. Experienced with configuration management tools and processes to maintain system integrity and control. Utilizes version control and change management to ensure seamless project execution. Strong understanding of collaborative teamwork and adaptability in dynamic environments.
Overview
7
7
years of professional experience
Work History
Provider Configuration Management Analyst
Molina Healthcare
New York, New York
11.2021 - 10.2025
- Managed over 10 delegated entities, overseeing the database maintenance and data integrity for a network of 10,000+ providers.
- Reported on provider data metrics, providing quarterly rosters and complex extracts to ensure network health optimization and compliance.
- Coordinated with Credentialing and Claims Processing teams to troubleshoot and resolve system-wide provider configuration issues.
- Extracted and audited data for large-scale projects involving 5,000+ provider updates, maintaining 100% data quality assurance while training new staff on database standards.
- Audited provider credential records in MS Access and Excel to correct 200+ status discrepancies.
- Reconciled claims configuration entries against contract terms, reducing billing rejections for affected providers.
- Trained new hires on provider configuration standards and data-entry procedures using hands-on shadowing.
- Validated provider taxonomy and specialty mappings to align network directories with payor requirements.
- Performed monthly provider roster reconciliations across systems, flagging and correcting mismatches for audit readiness.
Provider Data Management Supervisor
Affinity Health Plan
New York, New York
10.2019 - 11.2021
- Supervised the management of 12 delegated entities, ensuring database integrity for approximately 9,000 providers in the health care network.
- Managed data reporting for provider teams, delivering quarterly rosters and identifying opportunities for database maintenance and accuracy.
- Facilitated relationship building and partnership with third-party vendors including Cognizant and Beacon to manage Pharmacy Benefits and integrated provider data.
- Coordinated database training and auditing for team members to ensure compliance with medical terminology and internal data quality assurance protocols.
- Trained staff on data-audit procedures and charting protocols, reducing documentation errors among new hires.
- Managed scheduled database clean-ups in MS Access and Excel, restoring accurate contract and specialty fields for providers.
Provider Data Specialist
Affinity Health Plan
New York, New York
07.2018 - 09.2019
- Managed 12 delegated entities, executing high-volume data entry and maintenance for 9,000 provider records.
- Reported on delegated rosters and provider data sets to support administrative reporting and network growth.
- Troubleshoot provider-related data discrepancies by coordinating with Credentialing and Provider Relations departments.
- Extracted data for large-scale updates involving 5,000+ providers to ensure continued data quality assurance.
- Validated updates for 9,000+ provider records by comparing source files and correcting database mismatches.
- Reconciled delegated rosters weekly using Excel pivot tables to flag missing or duplicate provider entries.
- Coordinated with Credentialing and Provider Relations to resolve provider credential discrepancies and close cases.
- Audited incoming provider contracts and loaded key fields into the system to maintain accurate network directories.
- Generated administrative reports on provider network coverage for leadership using Excel and scheduled automated outputs.
Education
High School Diploma - Computer Science
Mount Saint Michael Academy
Bronx, New York01-2007
Skills
- MS Excel, Data Entry, Reporting, Database Maintenance, Data Quality Assurance, Claims Processing, MS Access, PowerPoint, MS Outlook, MS Word, Cloud Storage, Provider Networks, Pharmacy Benefits, Health Optimization, Medical Terminology, Medical Coding, Credentialing Support, Troubleshooting, Contract Loading Support, Vendor Management, Relationship Building, Data Auditing, Teamwork, Attention to detail, Flexibility, Application support, Incident management
LANGUAGES
Spanish (Native)
Timeline
Provider Configuration Management Analyst
Molina Healthcare
11.2021 - 10.2025
Provider Data Management Supervisor
Affinity Health Plan
10.2019 - 11.2021
Provider Data Specialist
Affinity Health Plan
07.2018 - 09.2019
High School Diploma - Computer Science
Mount Saint Michael Academy