Billie Johnson

The role focuses on enhancing operational efficiencies by collaborating closely with the Account General Manager (AGM) and Client Delivery Leader (CDL) to manage the account effectively, ensuring adherence to Service Level Agreements (SLAs) and fulfilling client contract obligations. This includes overseeing the Customer Experience organization for the Mississippi MMIS, which encompasses various functions such as Claims Data Entry & Resolution, Member and Provider Services, Provider Enrollment, Managed Care, Finance, Mailroom, Credentialing, Quality Assurance and Training. Regular interaction with the client is essential to support operational services, while compliance with key performance indicators (KPIs) is reported monthly to both internal and external stakeholders. The management of a diverse team, including eight leaders, four independent contributors, and 112 frontline staff, involves directing daily activities, recruitment, budgeting, and implementing cost-saving measures. By establishing critical metrics, the role aims to achieve operational excellence and ensure that team objectives and contractual commitments are consistently met or surpassed. Additionally, collaboration with Centers of Excellence within the Customer Experience organization promoting best practices and standardization, while maintaining vendor relationships and overseeing their performance is crucial for addressing and resolving any implementation or operational challenges that arise.

Operational planning and execution to meet monthly service level agreements (SLAs), profit and loss (P&L) targets, revenue goals, and account margins. It includes managing the contractual relationship with clients within the Provider Data Management division and fostering collaboration with department heads to ensure compliance across the organization. Responsibilities also encompass conducting monthly and quarterly forecasts, overseeing the complete process for onboarding new Provider Data Management clients, and holding regular meetings with the team and quality assurance personnel to assess performance, review audit reports, and identify necessary corrective actions. Additionally, the position required implementing process improvements in coordination with the service excellence team to enhance audit mechanisms and overall service quality. Developed and refined work structures and workflows, standardize procedures for operational efficiency, assign tasks, and ensure adherence to policies. Furthermore, the role included guiding a team of 2 supervisors and managers with oversight of approximately 50 frontline employees to deliver prompt, courteous, and accurate client responses while maintaining operational effectiveness through strategic planning and organization, alongside supporting employee engagement and professional development.

The role involved overseeing and optimizing operational areas and functions with a strong focus on execution, outcomes, continuous improvement, and performance enhancement. This included managing the entire process for effective network implementation, credentialing, provider services, and resolving escalations. Additionally, the position entailed directing contractual relationships with vendors across Dental, Hearing, Vision, and Credentialing services while supervising a team of over 40 employees across various operational areas such as Contracting, Credentialing, Provider Data Management, and Provider and Member Relations. Responsible for tracking reports in the Customer Relationship Manager (CRM) tool to ensure compliance with state and government regulations, developing and maintaining policies and procedures aligned with best practices, and collaborating with internal leaders to streamline the credentialing process. Furthermore, the role included planning and executing a risk-based audit strategy, delivering results to senior leadership, assisting IT in prioritizing operational work requests, and managing key performance metrics within service areas. The position also required oversight of dashboarding and analytics for operational areas to present to executive leadership, applying LEAN principles to eliminate inefficiencies, and managing departmental budgets.

Implemented policies and procedures to ensure that departmental goals are consistently achieved on a daily, weekly, and monthly basis. Evaluated operational trends and proactively adjusted strategies to align performance with objectives, while leading departmental reinventions to enhance productivity. Planned daily workflows for a team of five Provider Relations Network Managers and collaborated closely with stakeholders to swiftly address issues and implement effective solutions. Motivated and supported the team to improve work quality and efficiency, while maintaining Pareto Charts to track outstanding work inventory and ensure timely completion of tasks. Established daily Tier accountability huddles for reporting metrics and escalating concerns to senior leadership, and initiated process improvements for FileBound workflows related to contract and credentialing storage. Reviewed standard contract language and redlines, ensuring high levels of staff engagement, empowerment, and development. Assisted in the review and testing of contracts, overseeing the setup, post-configuration testing, maintenance, and auditing of the claims system, while collaborating with relevant personnel on the reassignment of members due to provider terminations as mandated by state requirements.

Established a comprehensive framework for monitoring customer service performance by implementing daily, weekly, and monthly metrics for both individuals and departments. Enhanced customer satisfaction through the introduction of robust quality assurance practices, while also devising daily operational strategies that encompassed team workflows and promotional activities. Focused on employee development of 15 employees by training and mentoring underperforming staff, offering regular performance evaluations, constructive feedback, and targeted coaching to address specific weaknesses. Improved operational efficiency by creating daily metrics that tracked service levels, average response times, abandonment rates, and overall quality. Fostered strong relationships with customers by ensuring timely responses to inquiries via the online portal, adhering to established turnaround times. Utilized the Customer Relationship Manager (CRM) tool to monitor reports, identify service issues, and facilitate customer engagement across all organizational levels, while conducting performance reviews that provided valuable coaching and feedback for the benefit of both the company and its employees.

A comprehensive framework was established to monitor customer service performance through the implementation of daily, weekly, and monthly metrics for individuals and departments. Customer satisfaction was enhanced by introducing effective quality assurance practices and developing daily operational strategies that included team workflows and promotional activities. Employee development was prioritized by training and mentoring underperforming staff, providing regular performance evaluations, constructive feedback, and targeted coaching to address specific areas for improvement. Operational efficiency improved with the creation of daily metrics that tracked service levels, average response times, abandonment rates, and overall quality. Strong customer relationships were fostered by ensuring timely responses to inquiries via the online portal, in line with established turnaround times. The Customer Relationship Manager (CRM) tool was utilized to monitor reports, identify service issues, and facilitate customer engagement across all organizational levels, while performance reviews offered valuable coaching and feedback for the benefit of both the company and its employees.