Happenings
Celebrating June Associates of the Month
Division 28 - Jurisdiction M Operations
Jessica Gibert
Since stepping into a new role as a Senior Medical Reviewer, Jessica Gibert has quickly become an integral member of the Jurisdiction M Operations team. She approaches challenges with enthusiasm and resourcefulness and readily helps colleagues find solutions. Her strong work ethic has helped her learn her role quickly and build positive relationships with coworkers along the way. Her willingness to step in whenever needed helps coworkers address questions and better serve providers. Jessica’s positive approach and early contributions have made a positive impact in a short time.
Division 6M – Audit & Reimbursement
Michael Hayes
Micheal Hayes, Accountant Technician III, helps keep appeals work moving by completing entries accurately and ensuring correspondence reaches the appropriate auditors. Since joining the Audit & Reimbursement department in October, Micheal has learned a complex workload quickly and regularly completes demanding assignments ahead of deadlines. He takes time to understand each process and asks questions when clarification is needed, preventing errors and keeping daily work on track. Micheal also promptly directs questions from provider representatives to assigned auditors so they can be addressed. His attention to detail and responsive communication have made him a valued member of the department.
Division 10 – Support Operations
Joe Holt
State agencies and internal teams rely on Joe Holt to keep enrollment questions moving toward resolution. As a Business Analyst II, he manages shared inboxes for Part A enrollment and state agency inquiries and earns positive feedback for his timely, careful responses. During weekly meetings with state agencies, Joe serves as a subject matter expert and makes sure analysts have the information needed to complete enrollment actions. He also researches complex applications and offers practical guidance to teammates, including during training. By sharing his knowledge and looking for more efficient ways to work, Joe helps the department maintain productive relationships with its state partners.
Division 54 – Finance & Accounting
Sherise Jones
During a recent high-volume period, Sherise Jones, Accounting Technician II, earned positive feedback for the attention and thoughtful guidance she gave each customer while keeping up with demand. She brings the same care to her daily work, checking details closely and sharing helpful practices with coworkers. Sherise also contributes to process improvements by reviewing current procedures and inviting teammates to identify better ways of working. Her approachable manner encourages open communication and helps the team work through challenges together.
Division 4M – Prior Authorization Programs
Joni Mahon
For six weeks beginning in May, Joni Mahon helped prepare a group of new medical reviewers for their roles while mentoring a colleague who was teaching for the first time. As a training and Quality Assurance Coordinator, Joni encouraged questions and open discussion as the class worked through challenging medical review material. She shared teaching responsibilities with the new instructor, providing guidance while giving her room to build confidence. Throughout the course, Joni kept the focus on the learners, celebrated their progress and prepared both the reviewers and the instructor for future success.
Division 34 – Systems & Support
Dilip Nepali
Dilip Nepali, Senior Developer, improved how the organization manages access to administrative tools by developing a system that assigns permissions based on each user’s responsibilities, along with a dedicated administrator interface. He added layered testing and built-in checks to help prevent incorrect settings and unintended access changes. By collaborating with quality assurance staff, he helped make the new tools practical and supported a smoother rollout. Dilip also created demonstrations and written guidance while mentoring teammates. Together, these improvements have made administrative access easier to manage, review and maintain consistently.
Divisions 5/29 – Appeals
Karen Schmitt
After recently training to complete Part A inpatient and Inpatient Rehabilitation Facility reviews, Karen Schmitt quickly put her new knowledge to work. As an Appeals Analyst, she readily accepts additional cases during heavier workloads and assists colleagues across Jurisdictions J and M. Her careful reviews help the department meet quality and timeliness expectations, while her detailed appeal letters give providers guidance they can apply to future claims. Karen also asks questions when clarification is needed, shares what she learns and remains available to help teammates. She is active in team activities which further reflects her commitment to the people she works with.
Division 93 – Augusta Operations
John Sessions
When time-sensitive letters must be printed and mailed the same day, the Benefit Integrity Unit can count on John Sessions, Document Preparation Clerk. John handles each request promptly and confirms when the mailing is complete, allowing others to meet critical deadlines. Throughout his years with Augusta Operations, he has also accepted assignments beyond his usual responsibilities without hesitation and approaches them with care. His work may happen behind the scenes, but his reliability keeps important correspondence moving and ensures teams across the organization receive support when they need it.
Division 1M – Customer Service
Zakaya Stephens
Zakaya Stephens, Training Specialist II, makes complex information easier for new hires and experienced staff to understand. During biweekly and new-hire sessions, she uses clear explanations and interactive activities, including a Jeopardy-style game that teaches associates how to use department resources. Her guidance continues beyond the classroom as she checks in during nesting and steps in when additional help is needed. Zakaya also developed an internal reason-code reference tool and job aids to support the department’s transition to a new resource platform. These materials give employees practical guidance they can return to after training, building confidence and greater consistency in their work.
