Coach of the Quarter – Allison McLeod

Allison McLeod is a Supervisor for Provider Outreach and Education. She is responsible for training and guiding the development of her team members' skills, knowledge, and talent. Allison consistently promotes quality throughout the organization and exceeds departmental quality objectives. Her exceptional performance is demonstrated by her ability to organize teams, document results, and successfully achieve goals and missions. She consistently provides superior service to customers and supports the strategic plan, contributing to quality and process improvement. We are thrilled to announce Allison as our Division 1M5M6M Coach of the Quarter for her hard work and dedication to promoting quality.

Team of the Quarter – Part B Provider Call Center Coaches

Seleta Woodberry and Martha M. Roberts make up the Part B Provider Call Center (PCC) Coaches Team. They are responsible for coaching all the PCC telephone agents. Their main objective is to ensure that all Customer Service Advocates (CSAs) are well-trained in chat, live listening, and side-by-side training on navigating through calls and ensuring the information provided is correct.

To promote quality, they developed Themed Training, where they dress up based on a particular theme. This approach has been very popular among the agents, and it has helped to keep them more engaged. Since both coaches worked as CSAs, they worked collaboratively and effectively to ensure that all CSAs came away with a wealth of knowledge, pride, and confidence to perform their job well.

Congratulations to this team for being named our Division 1M5M6M Team of the Quarter. Well done!

Team Members - Martha M. Roberts and Seleta Woodberry

Process Improvement of the Quarter – Appeals and Reopening's

Before the implementation of the new process, a direct document checklist to help review documentation consistently didn’t exist. To address this issue, a checklist or review template, along with a form letter, was developed and uploaded into QMS 360. These tools have proven to be very useful, as they provide both new and existing staff with a valuable resource that guides them through the Substantive Claim Review (SCR) process.

Since the implementation of this new process improvement, the approach has become more organized, consistent, and efficient. On average, the Appeals and Reopenings team can now complete around 50 SCRs each year, and this new process has significantly streamlined the workflow.

We would like to extend our congratulations to the Appeals and Reopenings team for their outstanding efforts, which have resulted in this process being named our Division 1M5M6M Process Improvement of the Quarter.

Team Members - Takiyah Adams, Kelly Bultema, Brandy Gilbert, Brenda Petke, Chari Preacher, Ebony Starr-Batie, and Shari Williams

Associate of the Month (June) – Lilia Santos

Lilia Santos is an exceptional Customer Service Advocate who consistently provides superior service to our customers. She has been instrumental in promoting quality throughout our organization and has consistently met or exceeded departmental quality objectives as a Customer Service Advocate II. Her colleagues hold her in high regard, and new hires have shadowed calls with her to learn how to conduct day-to-day phone operations. Lilia is known for supporting the communication of ideas from all associates and is committed to teamwork by assisting with achieving team goals and encouraging other team members. Most recently, she has worked with teammates to create and implement multiple process improvements for her department. We are proud to recognize Lilia's hard work and dedication by awarding her our Division 1M5M6M Associate of the Month. Congratulations Lilia!