Delphia Dent Leffew Email & Phone Number

Chattanooga, TN, US

United States

Chattanooga, TN

• Risk mitigation across client, claims, call, provider, compliance, and legal lines while ensuring Cigna brand representation externally
• Internal Audit project management including negotiation, report response, and remediation.
• SOC and SOX relationship management with PWC with project overview.
• Own analytics and process improvements.
• Liaison to all business as Subject Matter Expert for client and provider external presentations aligned to operations, quality, and audit.
• Primary contact for Legal support across Service Operations.

• Management and development of a team of External Audit Project Managers ensuring their success through audit challenges they face as the face of Cigna while exceeding team goal of 90% pass rate.
• Service Operations lead reviewing Legal/ Compliance escalated items.
• Managed Internal Audits: COVID, CMS, Provider Contracting resulting in successful representation of the business
• Own analytics and opportunities to strengthen matrix partner relationships: Sales, Service, Claim, Call, Provider, Appeal, Legal, and Compliance
• Quality liaison for high profile clients: JPMorgan Chase, Lockheed Martin, and HCA.
• Implementation of claim payment, Service, and Sales quality improvement initiatives.

• Management of complex external third-party audits including negotiations and remediation.
• External client facing presentation of audit findings and remediation efforts.
• Ownership of relationship with TOP 3 audit firms: AON, Willis Towers Watson, and Mercer.
• Partnered with external firms which represented ASO clients interest in audit.
• Own analytics and opportunities for team to drive process improvements.
• Quality liaison for high profile clients: JPMorgan Chase, Lockheed Martin, and HCA.

• Manage 40 virtual quality review staff.
• Own medical claim high dollar pre-disbursement audit program exceeded annual savings goal of $215M.
• Management of post pay performance guarantee audit program for medical claims.
• Own relationship with Global Service Partners- mentoring, collaboration, and monitoring Service Level agreement obligations.
• Project lead for Risk Mitigation Quality innovation and subject matter expert. Lead system enhancements which lead to $1 Billion in company/ client savings.

Chattanooga, Tennessee, United States

• Management of 27 Regional ASO clients representing 585K lives as the face of Cigna to investigate and remediate client concerns across all US Commercial business.
• Implemented 157 employer accounts for successful benefit application by clearly presenting insurance policy options based on client’s needs and goals in US Commercial market.
• Developed professional relationships with external consultants such as- AON, Mercer, Willis Towers Watson, Lockton, and Brown & Brown.

Chattanooga, Tennessee