1. Debra A. Jones
7777 Normandy Blvd Apt 1218
Jacksonville, Florida 32221
Mobile: 757-316-6328
Email Address: Jon7debor@aol.com
Resourceful visionary and savvy leader offering a rich mix of experiences in customer service, claims, human
services, healthcare commercial insurance, Medicaid, Medicare, and sales,
Excel in the management and mentoring of others with an innovative approach that encourages and enables
attainment/exceeding of imposed goals and objectives, a collaborative team approach and the desire to
succeed.
PROFESSIONAL HISTORY
Utilization Management Manager 1
December 2012 – April 2015
Anthem BCBS –Virginia Beach VA
 Managed 32 Case Specialists within the referral/preauthorization unit.
 Monitored work quality and performance evaluation, and issued performance improvement plans
(PIPs) when necessary.
 Created and prepared a variety of daily, weekly, monthly, and annual reporting’s for distribution to
management, administrators, staff, and client base
 Monitored call volumes, productivity metrics and staff daily adherence ratings.
 Served as departmental liaison to internal and external associates and customers.
 Assisted with contract implementations, managed program activities, monitored program compliance,
gather information, analyzed data, evaluated trends, and developed plans of action.
Eligibility Supervisor
October 2008 to August 2011
First source LLC – Portsmouth, VA
 Managed 16 Medicaid/Disability Eligibility Service Reps, which included interviewing, hiring, and
training new staff members.
 Facilitated team meetings, hiring, scheduling, payroll, employee development and, work assignments.
 Promoted public relations; resolved and provided timely responses to concerns, complaints, and
conflicts
 Coordinated the delivery of services among various departments and services.

2. Page 2 Debra A. Jones
Substitute Teacher
September 2007 to October 2008
Portsmouth Public Schools – Portsmouth, VA
 Designedand implemented lessonplans for children at different learning levels.
 Utilized a variety of lessonmethods including cooperative learning, projects, discussion, games
and discovery.
 Participated in school events such as PTA, Open House, and team leader meetings.
Senior Outreach Specialist
July 1998 to April 2007
Anthem BCBS – Virginia Beach, VA
 Developed and fostered partnerships and awareness in the community
 Managed community outreach initiatives and group presentations.
 Participated on boards and committees to increase awareness of the health plan.
 Coordinated community health fairs and special events.
 Made home visits to new and existing Medicaid members to promote healthy lifestyles and program
compliance.
Provider/Member Service Representative
November 1996 – July 1998
Anthem BCBS Virginia Beach, VA
 Handled inbound telephone inquiries
 Verified plan benefits
 Investigated and resolved service issues
 Coordinated member transportation.
EDUCATION
Saint Leo University 2006
Saint Leo, FL
Bachelor of Arts (BA)
Major: Sociology Minor Criminology