Luis Alamo

Results-driven Business Intelligence & Configuration Analyst with 8+ years of experience in the healthcare industry, specializing in Medicare, Medicaid, and Marketplace operations. Expert in QNXT configuration (v5.6/5.9), NetworX, SQL, and Power BI for data validation, analytics, and process optimization. Proven success in implementing system enhancements, improving configuration accuracy, and ensuring compliance with CMS and organizational standards.

Business Service Consultant - NCWorks

(2026-03)

• Serve as the primary point of contact for employers, building and maintaining strong relationships to support workforce needs and promote workforce development services.
• Identify employer hiring needs and deliver customize recruitment solutions, including job order development, candidate sourcing, and referral coordination.
• Coordinate with internal teams to match qualified candidates to employer openings and ensure timely follow-up on referrals and hiring outcomes.
• Support and manage Work-Base Learning activities, including OJT contracts, documentation, monitoring, and compliance with local and state policies.
• Serve as the single point of contact for OJT agreements, including contract development, employer eligibility review, reimbursement tracking and progress evaluation.
• Represent the organization in collaboration with economic development partners and community organizations to support regional workforce initiatives.
• Participate in required meetings, trainings and continuous improvement efforts.

Configuration Analyst - Multiple Contract Positions

(2025-02)

• Collaborated with different businesses as a contract employee to work on QA teams to resolve defects and support configuration testing, ensuring accuracy and compliance through proactive data reviews and audit readiness.
• Manage NetworX Rate Sheet and Global Rate Sheet configuration to support pricing accuracy.
• Maintain Qualifier Group configuration and fee schedule updates in NetworX.
• Conduct claim testing and data analytics using MySQL 19 to validate system performance and compliance.
• Managed Provider Configuration: created and modified provider networks, contracts, and affiliations per health plan requests.
• Oversaw Contract Configuration Management, including updates, service group maintenance, and termination processes.

Sr. Configuration Analyst - Molina Healthcare

(2022-01 - 2024-12)

• Collaborated with different businesses and QA teams to support configuration testing.
• Configured provider, member, and benefit data within QNXT 5.9 & NetworX Pricer, ensuring 100% compliance with CMS and internal standards.
• Developed and maintained documentation standards and process improvement initiatives.
• Loaded and maintained contract, benefit, or reference table information into the claim payment system and other applicable systems.

Business Analyst - MMM Holdings

(2020-01 - 2022-12)

• Gathered business requirements and developed performance reports using SQL and Power BI.
• Provided analytic consultation to support Medicaid Member Eligibility & Enrollment systems.
• Created and published periodic reports and ad hoc reports.
• Developed performance indicators and tracked mechanisms to monitor and report results. Oversaw, prepared, reviewed, and analyzed reports and controls for projects and initiatives for both internal and external use.

Master's Degree - IT System Security & Fraud Investigation - EDP University

Bachelor's Degree - Business Administration - UMET