Delphine Johnson

Streamlined processes to improve efficiency in sales operations.

Managed and streamlined service operations for Lucent Technologies and AT&T to enhance efficiency.

Coordinated project management activities by issuing orders and supervising progress from inception through to successful completion.

Oversaw interactions between premise technicians and special services technicians to enhance service delivery. Coordinated account activities to streamline operations and improve team collaboration. Fostered relationships with technical teams to drive effective problem-solving initiatives.

Assisted executives and managers in daily operations. Supported technicians with troubleshooting and maintenance tasks. Collaborated with various departments to streamline processes.

Coordinated interdepartmental communication within BellSouth to streamline processes and improve service delivery.

Developed and documented complex technical orders to streamline processes and ensure compliance.

Directed supervision of PBX maintenance revenue base to support financial stability.

Oversaw administrative functions to enhance operational efficiency. Coordinated with stakeholders to align project objectives with state regulations. Facilitated team meetings to drive project progress and accountability.

Redesigned existing customer database structure to improve operational efficiency and data management.

Acquired in-depth expertise in T-1 Centrex and PBX services.

Conducted comprehensive time studies for BellSouth to enhance operational efficiency.

Streamlined customer service operations to improve response times and satisfaction levels.

Coordinated activities of maintenance technicians and engineers to support facility operations.

Established benchmarks and optimized processes to drive efficiency improvements.

Created detailed management reports summarizing services activated and corresponding revenue figures.

Executed generation of innovative ideas and solutions.

Oversaw collaboration between account executives and sales managers to enhance client engagement. Facilitated training sessions to improve team performance and efficiency. Drove initiatives that strengthened client relationships and increased satisfaction.

Identified and pursued potential leads to drive commercial business growth.

Negotiated and formalized agreements with clients to establish clear expectations.

Developed and implemented access database for tracking market client products.

Assisted in delivering services to clients by coordinating schedules and resources. Supported team members in achieving project goals through effective communication. Contributed to maintaining high standards of service quality.

Facilitated training sessions for account executives and application engineers to enhance product knowledge and sales effectiveness.

Established guidelines and protocols to ensure compliance and enhance service delivery for Alltel products and services.

Facilitated seamless installation and transition experiences for new Alltel customers to enhance service delivery.

Provided comprehensive instruction to new customers on operational features of newly installed services.

Facilitated comprehensive project management activities, coordinating resources and timelines to achieve project objectives.

Supported service maintenance at Alltel Jacksonville campus, ensuring operational continuity and reliability.

Oversaw ongoing campus project from 1999 to 2003, guiding teams through project phases. Facilitated collaboration among stakeholders to achieve project objectives. Championed effective communication strategies to enhance project visibility.

Managed comprehensive telecom services conversion at Alltel Stadium, ensuring seamless integration and functionality.

Oversaw network operations for Alltel, ensuring seamless connectivity. Coordinated with technical teams to resolve network issues efficiently. Implemented strategies to improve overall service quality.

Managed the migration of telecom services to Alltel network, ensuring seamless connectivity for hotel operations.

Implemented processes to streamline workflows and improve productivity.

Transitioned telecom services to Alltel, enhancing operational efficiency.

Oversaw network infrastructure projects to enhance connectivity and performance. Coordinated with cross-functional teams to implement network solutions. Developed strategies for optimizing network efficiency and reliability.

Collaborated with regional sales manager to align sales strategies and objectives.

Delivered technical support to six account executives in the Northeast region.

Assisted in coordinating activities within Florida region. Supported team members in achieving project goals, Contributed to maintaining effective communication across departments.

Produced comprehensive technical reports. Fostered customer relationships to align project goals and deliverables.

Assessed current service protocols and suggested enhancements to optimize location performance.

Secured and maintained new and established client accounts.

Partnered with regional sales manager to enhance sales strategies aimed at maximizing revenue.

Oversaw operations within Jacksonville office territory, including Daytona, Melbourne, and Orlando. Managed client engagement strategies to enhance service delivery in these areas. Developed and implemented travel plans to optimize regional outreach.

Led special time study project selection process, demonstrating expertise in project management.

Streamlined procedures for converting customers to GTE, improving overall service delivery.

Collaborated with support department office managers to enhance platform functionality.

Oversaw interdepartmental collaboration to streamline processes and improve service delivery. Coordinated staff support initiatives to enhance team performance and project outcomes. Fostered a culture of teamwork and accountability across departments.

• Lead CMS‑regulated operational initiatives supporting multiple enterprise healthcare clients, including Centene, HCSC, CareSource, Medical Mutual of Omaha, Cigna, Medical, and Longevity
• Serve as primary operations and compliance liaison for assigned clients, ensuring adherence to CMS requirements, contractual obligations, and performance standards
• Manage and oversee CMS complaint analysis and resolution activities across client portfolios, identifying trends, risks, and corrective action needs
• Responsible for the monthly and annual implementation, execution, and sustained compliance success of the Medicare Vaccine Program and Excluded Provider Program for designated clients
• Coordinate cross‑functional teams to ensure accurate program execution, documentation, and audit readiness across all client engagements
• Monitor client‑specific operational metrics, complaint drivers, and regulatory indicators to proactively address compliance gaps
• Prepare and present client‑level compliance updates, risk assessments, and performance findings to internal leadership
• Ensure standardized processes, quality assurance controls, and documentation practices are consistently applied across all client programs
• Maintain current knowledge of CMS guidance and client‑specific regulatory requirements to support compliant operations and continuous improvement

• Supervised day‑to‑day FEMA revalidation operations, assigning workloads and monitoring task completion to meet mission objectives and Service Level Agreements (SLAs)
• Monitored employee performance to ensure strict adherence to FEMA protocols, operational procedures, and quality standards
• Partnered closely with Quality Assurance (QA) teams to validate accuracy, consistency, and compliance with federal requirements
• Researched, responded to, and resolved escalated applicant and client inquiries in a timely, professional, and customer‑focused manner
• Ensured compliance with company Wage & Hour policies, including verification of required rest and meal breaks for non‑exempt employees
• Evaluated employee performance and recommended appropriate personnel actions, including coaching, corrective action, and recognition
• Conducted performance discussions with staff to identify root causes of performance issues and develop corrective improvement plans
• Collaborated with Human Resources to address employee relations matters and support resolution of performance or conduct concerns
• Identified training gaps and development needs; coordinated targeted training and coaching to improve accuracy, productivity, and compliance
• Maintained team productivity during high‑volume disaster response operations while supporting employee morale and accountability

• Supervised day‑to‑day unemployment assistance operations supporting the Florida Department of Economic Opportunity (DEO)during the COVID‑19 pandemic
• Assigned and monitored daily workloads related to claim revalidation and application updates to ensure timely claimant payments
• Oversaw employee performance to ensure compliance with established Service Level Agreements (SLAs), policies, and procedures
• Partnered with Quality Assurance (QA) teams to validate accuracy, consistency, and adherence to program requirements
• Researched, responded to, and resolved escalated claimant inquiries professionally and within established timelines
• Ensured compliance with Wage & Hour policies, including verification of required rest and meal periods for non‑exempt staff
• Evaluated subordinate performance and recommended personnel actions including coaching, corrective actions, and recognition
• Conducted performance discussions to identify root causes of issues and collaborated with Human Resources on resolution strategies
• Identified training needs and development opportunities to improve staff accuracy, productivity, and service delivery
• Provided coaching to agents to ensure unemployment applications were complete and compliant, reducing payment delays
• Led ad‑hoc projects to remove workflow bottlenecks and improve operational efficiency during periods of high demand
• Supervised, coached, and motivated staff to develop competencies while maintaining morale in a high‑volume crisis environment
• Communicated project updates, policy changes, and procedural guidance to staff, ensuring understanding and compliance
• Supported incentive programs, performance metrics, and call‑handling skill development to improve results
• Ensured staff met performance, quality, productivity, and attendance standards; tracked and communicated operational metrics
• Monitored progress against goals and implemented corrective actions as needed
• Encouraged continuous improvement through team engagement and structured process improvement efforts
• Collaborated with supervisory peers to build consensus, share responsibilities, and resolve conflicts
• Assisted Human Resources with interviews, onboarding, and processing voluntary and involuntary separations
• Maintained attendance records, processed employee documentation, and submitted payroll information accurately and on time
• Led team meetings and facilitated communication, ensuring follow‑up and documentation of action items

• Delivered direct customer support for non‑insurance healthcare products, providing technical guidance, issue triage, and non‑sales problem resolution
• Applied enterprise knowledge resources (CRM tools, SharePoint, knowledge bases, system manuals) to investigate and resolve complex issues
• Conducted initial problem analysis to determine scope, impact, and root cause of customer and system issues
• Supported installation, testing, and implementation of new software and procedures; identified inefficiencies and coordinated corrective actions
• Maintained hands‑on experience with claims and processing platforms including COSMOS, UNET, Facets, and Diamond.
• Managed CMS system security access to ensure employee compliance with Medicare, Part D, Optum, and Retirement requirements.
• Delivered system, product, and process training to staff and supported development of user guides and job aids
• Identified recurring system and process issues and recommended documentation and procedural updates to internal product and operations teams
• Ensured accurate documentation of investigations, actions taken, and final resolutions
• Updated and maintained claims process documentation to reflect regulatory and operational changes
• Coordinated with cross‑functional teams (IT, Operations, Product, Compliance) to resolve escalated issues
• Provided consulting and education on claims platforms and pharmacy tools including RxCCR and PhBIT
• Evaluated new application access requirements, version dependencies, and compatibility with existing environments
• Supported application deployments and ensured standardized system usage and data entry across teams and regions
• Facilitated coding, definitions, and workflow review meetings with management
• Assisted in development of application workflows, training plans, user materials, and job aids.
• Troubleshot individual user system and data entry issues
• Acted as business liaison to IT during large‑scale application, network, and telephony incidents
• Triaged incidents, assessed impact, and determined priority levels
• Represented business operations during IT war‑room calls through incident resolution
• Communicated incident status, workarounds, and contingency plans to leadership and staff
• Tracked and reported issues with potential compliance, audit, or regulatory impact
• Managed outage communications and coordinated workarounds during large‑scale disruptions

Assisted clients by providing detailed answers to challenging benefit-related questions.

Led initiatives to investigate and resolve inquiries and exceptions. Oversaw issue resolution processes to enhance service delivery. Championed strategies to streamline operations and improve response times.

Facilitated customer comprehension of company offerings and procedural workflows.

Facilitated educational sessions on flexible spending accounts (FSA) to enhance member understanding.

Reimbursement Accounts (HRA) and Health Saving Accounts (HSA)

Organized and managed outbound call cases to enhance triage specialist operations.

Led initiatives to improve collaboration among nurses, community specialists, and physicians. Oversaw communication between providers and members to streamline healthcare delivery. Championed efforts to enhance patient engagement and satisfaction.

Coordinated follow-up activities for inquiries, appointments, referrals, and educational sessions to ensure comprehensive communication.

Provided comprehensive support to members in evaluating cost differences among various benefit options.

Educated members on utilizing self-service tools. Provided guidance and support for tool navigation. Assisted in referring members to appropriate resources.

Facilitated member education on adjunct programs, including Health Dialog.

Streamlined care coordination processes to enhance patient outcomes and satisfaction.

Facilitated member comprehension of medical benefits and provided educational resources.

Implemented effective patient care protocols in health insurance, utilizing 8 years of experience to optimize physician engagement and patient outcomes.

Assisted members with inquiries regarding BCBSF and Florida Blue services. Supported team in delivering accurate information to enhance member satisfaction.

Assisted in identifying disease states and health conditions. Supported referral processes to appropriate specialists. Collaborated with healthcare teams to enhance patient care.

Coordinated member access to essential services and benefits, focusing on health dialogue support.

Evaluated provider contracts and reimbursement strategies to ensure compliance and optimize financial performance.

Oversaw the administration of provider fee schedules and monitored participation status. Coordinated efforts to optimize contracted lines of service. Led initiatives to ensure compliance with provider agreements.

Assisted in daily business operations to support team objectives. Collaborated with colleagues to streamline processes and improve efficiency. Provided administrative support to enhance project coordination.

Experience utilizing multiple research and processing systems (Siebel, Diamond, RBMS, or CMCA)

Experience working with Diamond claim adjustments

Experience with health and specialty products: Blue Options (including high deductible and non-standard contracts), Health Reimbursement Accounts, Healthcare Savings Accounts or Flexible Spending Accounts

Experience with care support programs (Care Coordination, Health Dialog, Retail Health, etc.)

Experience in collecting and summarizing data, identifying trends and root cause.

• Provided customer service support to health plan members and healthcare providers by answering benefit inquiries, resolving issues, and explaining products, policies, and processes
• Conducted research and responded to telephone and written inquiries from providers, physicians, attorneys, and billing agents
• Screened, validated, and processed sensitive provider enrollment information in accordance with CMS requirements
• Verified provider credentials, licenses, and application data to ensure accuracy and regulatory compliance
• Identified and escalated cases of suspected fraud or inconsistencies for further review
• Researched and obtained additional documentation required to complete provider enrollment applications
• Served as liaison between providers and internal departments to ensure timely resolution of complex issues
• Created and maintained provider enrollment records within the Provider Enrollment Chain & Ownership System (PECOS)
• Applied ICD‑9 and ICD‑10 codes to verify compliance with Medicaid and Medicare guidelines
• Utilized Multi‑Carrier System (MCS) and Fiscal Intermediary Shared System (FISS) to support enrollment and compliance activities
• Ensured accurate documentation and adherence to federal healthcare regulations and organizational procedures