James W. Ross
Sellersburg,IN
Summary
Innovative technology professional with several years of diverse experience. Skilled in enhancing systems and aligning technical solutions with business objectives. Proven success in leading projects from start to finish and contributing to organizational growth and success.
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
28
28
years of professional experience
Work History
Network Adequacy Professional 2
Humana Government Business (Humana Military)
Louisville, KY
11.2018 - Current
- Developed and oversaw comprehensive reports identifying and capitalizing on lost revenue opportunities, enhancing financial outcomes
- Conducted detailed analyses and audits on strategic cost savings, provider data, and network data, ensuring high accuracy and operational efficiency
- Coordinated and led rigorous audits and implementations to improve network adequacy, boosting service quality and compliance
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Learned and adapted quickly to new technology and software applications.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Provider Data Management & Contract Load Professional 2
Humana Government Business (Humana Military)
Louisville, Ky
03.2018 - 11.2018
- Strategically coordinated and executed comprehensive audits and implementations for Tricare contracts, ensuring stringent adherence to regulatory standards and optimizing contract performance
- Proactively identified key areas for cost savings and efficiency improvements, leading initiatives that significantly enhanced operational effectiveness
- Managed and safeguarded sensitive and classified materials, maintaining strict compliance with legal and company guidelines to protect information integrity
- Spearheaded the development and implementation of progressive policies and changes, streamlining workflow processes and boosting overall workplace productivity
- Paid attention to detail while completing assignments.
Provider Data Management & Contract Load Professional 3
Humana Government Business (Humana Military)
Louisville, Ky
01.2017 - 03.2018
- Diligently inspected and managed the loading of Tricare Agreements, ensuring accuracy and compliance with federal healthcare regulations, thereby upholding the integrity and reliability of contract executions
- Effectively tracked and reported emerging trends, issues, and concerns, enabling proactive problem-solving and decision-making to enhance operational efficiency and stakeholder satisfaction
- Demonstrated strong organizational and time management skills while managing multiple projects.
Medicare Customer Care Specialist
Humana Inc.
Louisville, KY
06.2014 - 01.2017
- Managed confidential information pertaining to claim audits and benefit verifications, ensuring rigorous data protection and accuracy in handling beneficiary records
- Served as a Subject Matter Expert (SME), authorizing and conducting comprehensive training for new hires and peers, significantly enhancing team competence and process consistency
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Utilized CRM systems to document interactions and track service requests efficiently.
- Trained new team members on best practices for customer engagement and issue resolution.
- Navigated multiple computer systems and applications to find information.
Picker/Trainer—Amazon Fulfillment
Amazon Fulfillment Center
Jeffersonville, IN
10.2013 - 06.2014
- Responsible for the coordination and execution of training for all process paths in a fulfillment center
- Evaluate and refine process to improve learning effectiveness and production
- Collaborated with team members to optimize picking routes for improved efficiency
- Completed inventory accounts to keep records current and promote accurate ordering.
- Monitored stock levels, reporting discrepancies to management for resolution
Sales Support Account Coordinator
Charter Communications
Louisville, KY
07.2009 - 10.2013
- Communicating regularly with clients to provide product updates and technical support
- Assembling promotional material to be sent to new and existing clients
- Managing account budgets and reporting to managers regularly on budget issues
- Developed and maintained detailed project documentation for tracking progress.
- Collaborated with cross-functional teams to address client needs effectively.
- Maintained detailed records of account activities, ensuring accurate invoicing and budget tracking processes were in place.
Environmental Services Manager
Health Care Service
Jeffersonville, IN
06.2007 - 06.2009
- Provide administrative, management, and professional leadership for the environmental and regulatory services program.
- Prepare, administer and monitor a division/department budget
- Effectively plan, assign, and direct a wide range of activities which promote compliance with environmental and regulatory mandates.
- Developed training programs for staff to improve efficiency in waste management practices.
- Evaluated vendor performance to enhance service delivery and cost-effectiveness of supplies used in cleaning operations.
- Conducted thorough facility audits, identifying potential environmental risks and recommending cost-effective solutions for mitigation.
- Managed regulatory compliance for all environmental permits, ensuring timely reporting and adherence to state and federal requirements.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
Supervisor
UPS
Louisville, KY
05.2002 - 05.2007
- Innovation and strategic plans to increase productivity for personnel and automated sorting facility
- Monitors daily activities of package handlers and clerks to ensure all assigned duties are accomplished safely and timely
- Supervised daily operations to ensure efficient package processing and delivery.
- Implemented workflow improvements to enhance productivity and reduce delays.
- Monitored compliance with company policies and safety regulations consistently.
- Collaborated with management to develop strategies for operational efficiency improvements.
- Led successful project completions under tight deadlines, coordinating effectively across multiple teams.
Diesel Mechanic and Motor Transport Chief
United States Marine Corp
05.1998 - 05.2004
- Accountable to the commander for assisting in the strategic planning, training, deployment, and management of all crew/operator level maintenance, ensuring operational readiness and efficiency
- Led the planning and execution of motor transport operations, orchestrating seamless logistics and operational flow to meet stringent project deadlines
- Coordinated the meticulous preparation and assignment of personnel and equipment, optimizing resource allocation and enhancing operational effectiveness
- Diagnosed and repaired diesel engines, ensuring optimal performance and reliability.
- Conducted preventive maintenance on military vehicles, enhancing operational readiness.
- Mentored junior mechanics in advanced diagnostic techniques and repair strategies.
- Streamlined workflow processes, reducing vehicle downtime during maintenance operations.
Education
General Business -
Western Kentucky University
Skills
- Microsoft Office Products
- CCP/GCP Applications
- CRM Intranet Services
- Evips
- WPS
- SQL
- CAS/CI
- Argus/RxNova
Accomplishments
- Attained 100% club achievement for meeting Quality evaluationsHumana
- Subject Matter Expert (SME) for new hires Humana
- Multiple Star Awards – Humana
- Member of the Salute NRG
Timeline
Network Adequacy Professional 2
Humana Government Business (Humana Military)
11.2018 - Current
Provider Data Management & Contract Load Professional 2
Humana Government Business (Humana Military)
03.2018 - 11.2018
Provider Data Management & Contract Load Professional 3
Humana Government Business (Humana Military)
01.2017 - 03.2018
Medicare Customer Care Specialist
Humana Inc.
06.2014 - 01.2017
Picker/Trainer—Amazon Fulfillment
Amazon Fulfillment Center
10.2013 - 06.2014
Sales Support Account Coordinator
Charter Communications
07.2009 - 10.2013
Environmental Services Manager
Health Care Service
06.2007 - 06.2009
Supervisor
UPS
05.2002 - 05.2007
Diesel Mechanic and Motor Transport Chief
United States Marine Corp
05.1998 - 05.2004
General Business -
Western Kentucky University