Ashley Delaney Email and Phone Number

▪ Promoted as Supervisor of Operations for ACA and MA lines of business subsequent to BCBS retrieving lines from outside vendor and bringing in-house.▪ Hired/developed entirely new team; grew to 13 personnel including 10 examiners, a Lead and two Liaisons. ▪ Cultivate internal and external relationships crucial to securing rapid and effective resolutions. Intermediary between departments to identify, triage, and resolve escalated issues. ▪ Document files and reporting for CMS audit in progress.▪ Responsible for creating SOPs for Medicare Advantage Program - reviewing medical policies, clinical edits and member benefits to achieve timely resolution of claims processing and adjustments.▪ Handle and troubleshoot Special Project Requests.▪ Participate in regular collaboration meetings with Customer Service, Pop Health, Provider team, and more to review escalated issues, systems errors, and SOPs, and to improve departmental processes.

▪ Promoted to Lead of 11 call center reps for the membership department. ▪ Selected for the CSRx Launchpad team which designed and implemented a new GUI for Operations to improve consistency and quality of the overall Blue KC customer service experience.▪ Coordinated closely with all Call Center Supervisors and Leads in weekly calibration meetings, to align our goals and strategies in call coaching and Customer Liaison development.▪ Selected as a subject matter expert in Operations to discuss department activities, workflows, current performance, and processes with Milliman Consulting. ▪ Created a Skills Matrix for membership department training and development. This document is a comprehensive list of the standard operating procedures and skillsets necessary for team members.

▪ Responded to providers’ and customers’ inquiries involving claims, benefits, contract allowables, coordination of benefits, authorizations, and appeals.▪ Selected to cross-train on FEP based on high efficiency and ability to quickly master new information.▪ Volunteered to sit with new hires to offer support and help to improve efficiency.▪ Halted 2-year-long, time-wasting inquiry submission practice involving hundreds of duplicate inquiries.▪ Subsequent to hire, quickly became proficient in Facets and consistently achieved 10-day goals for efficiency and quality processing.