Ericka Butts

• Supervised a team of 6-22 direct reports in updating Optima Health's provider network of 37K fee schedules, demographics, non-demographics, and terminations while maintaining a 95% external SLA.

• Ensured compliance with CMS standards for network contracting and reporting. • Improved provider update quality by 85% by implementing an online form with only applicable fields.

• Collaborated with senior leadership to establish metrics and ensure performance targets were met.

• Implemented a performance enhancement system resulting in increased timely processing of forms.

• Served as SME for provider relations and education in new business projects.

• Created workflows, policies, and procedures for department sustainability and scalability.

• Conducted research and analysis of privacy and security deficiencies for process improvements.

• Supervised a team of 12 employees, coordinated interviews and recruitment with HR, and managed day-to-day Call Center operations, including provider and member complaints and concerns, to ensure profitability and achievement of corporate goals.
• Improved Call Center operations by cross-training, resulting in a 20% increase in call process with the same number of employees.
• Worked with IT to redesign Call Center Reps' resource access, improving call time, metrics, and productivity.
• Developed, motivated, evaluated, and coached staff on work procedures, proper call handling, and teamwork, delivering excellent customer service.
• Guided Call Center Representatives through difficult calls and diffused situations with upset members, reducing provider abrasion.
• Generated reports and analyzed Call Center KPI metrics to improve processes, allocate resources properly, and maximize efficiency and customer satisfaction.
• Assessed individual and team performance regularly and provided candid and timely feedback on developmental and training needs, including monthly and annual scorecards.
• Established a clear vision aligned with company values, motivating others to balance customer needs and business success.
• Proactively analyzed constituent data and identified trends and issues, recognizing and acting on the needs to improve product and service development and delivery.
• Managed daily workflow and reporting to ensure business objectives were maintained and accurately reported, with resources aligned appropriately across function and/or service center.
• Ensured regulatory compliance and removed barriers to job performance.

• Managed broker sales CMS compliance and regulatory oversight
• Accountable for onboarding new agents and insurance agencies and providing leadership for all broker training and recertification
• Analyzed regulatory and contractual requirements to ensure business operations were in compliance
• Directed third-party vendor management for fulfillment and documentation management
• Coordinated with health plan managers to support broker activities
• Managed brokers training records and license appointments for CMS compliance
• Liaised with internal IT departments for systems implementations, testing, and feedback
• Provided operational support for internal and external brokers, Amerigroup Medicare health plan managers, insurance agencies, and internal departments.