Angela Jackson Email & Phone Number

Asheville, North Carolina, United States

• Provides oversight and management of member eligibility and enrollment activities.
• Developed a claims quality assurance program inclusive of desk level procedures, enhanced claims auditing processes and internal quality audit procedures.
• Manages planning, developing, and directing quality assurance policies, programs, and initiatives.
• Leads audit plan strategies, implementation, and audit readiness activities.
• Communicates with senior leaders and executives on quality initiatives and guidance for change management.
• Identifies and assists in the resolution of operational issues using well defined/documented processes, expertise, and judgment.

Charlotte, North Carolina

• Coordinated operational quality processes to support and increase successful claims adjudication.
• Maintained department operational quality over 95% through monitoring of claim system defects and manual processor errors identified in internal audits.
• Drove customer satisfaction of 90% and above through customer surveys, net promoter scores (NPS), and internal staff surveys.
• Championed change management for business processes, systems, technology, job roles, and redesign of organizational structure.

Charlotte, North Carolina

• Directed quality programs and enhanced cost savings through routine and focused claim audits, special reviews, projects and initiatives.
• Achieved customer satisfaction scores of 90% or higher and NPS of 50 or higher.
• Guided change management activities during new system implementations and organizational growth.
• Created and implemented over 15 leadership development training modules for department leaders.

Charlotte, North Carolina

• Provided leadership to data management personnel for provider and member enrollment.
• Developed claim audit program and improved audit compliance rate from 90% to 99% for processing and payment accuracy.
• Developed internal quality audit program and consistently maintained department quality scores of 97% or higher.

A 12 month leadership development program for women, which includes 12 sessions, on-the-job assignments, one-on-one and team mentoring by leading corporate executives, an individual development planning process, and networking and team-building exercises. The program is for high-potential women with a minimum of 7 years of managerial experience.

Charlotte, North Carolina

• Developed, initiated, and maintained policies and procedures for general operation of the corporate compliance program.
• Responded to alleged violations of fraud, waste or abuse through investigative procedures and prepared documentation for referrals to state regulatory agencies.
• Prepared and executed successful outcomes against provider legal challenges in local, state and federal hearings.

Charlotte, North Carolina

• Managed site audits and investigations to assess regulatory compliance of providers against federal, state and local service delivery requirements.
• Oversaw provider complaints and investigations. Prepared documentation for referrals to state regulatory agencies and court proceedings.
• Created policy and procedure for regulatory compliance activities.

Charlotte, North Carolina

• Established and administered a systematic process for developing contracts and monitoring providers.
• Ensured site audits of providers occurred within state and local required timelines.
• Prepared documentation for referrals to state regulatory agencies and court proceedings.
• Executed requests for proposal (RFP) and requests for information (RFI) processes to increase service delivery options.

Case ManagementChild and Adolescent Case Management SupervisorAdult Case Management Supervisor Provider Relations Specialist

Master'S Degree, Criminal Justice

Bachelor Of Science, Criminal Justice/ Psychology

Activities and Societies: Student Court, SAFE Counselor, Bill Mitchell Award Recipient