James C. Roberto
Brighton,MA
Summary
Creative entrepreneur who is passionate about turning innovative ideas into tangible results. Experienced formulating and executing strategic plans, creating new products and services, and developing business opportunities. Track record of multiple successful business ventures and leading teams of professionals to maximize profits and deliver success.
Overview
11
11
years of professional experience
Work History
Founder
TCG-JC
04.2019 - Current
- Founded collectibles shop with idea behind community experience for hobbyists that specializes in trading card games, sports, memorabilia, video games, and other special interests.
- TCG-JC predominantly runs through open community events on several social media platforms as well as in-person trade shows, typically hosting wide array of carnival games with prizes, live pack openings, raffles, giveaways, mystery boxes, claim sales, and so much more.
- Entire e-commerce experience surrounds interaction and engagement to bring community between customers who may share same niche interest or simple enjoy another's company.
- Responsible for engineering continuous flow of new and interactive prize games for all ages, creating all social media content, as well as monitoring prices and trends within market.
- Other responsibilities include bookkeeping, advertising, inventorying, and maintaining relationships with local businesses and places of interest such as hotels, sports stadiums, malls, churches, and exhibition centers.
Program Coordinator II
Executive Office Of Health & Human Services
05.2018 - Current
- Key member of MassHealth Claims Operations team under Governor’s jurisdiction - dedicated to improving health outcomes of MassHealth’s diverse members, families and communities by providing access to integrated health care services that sustainably promote health, well-being, independence and quality of life.
- Overseeing Claims and Provider Support tracking system for all internal and external escalated inquiries and issues regarding both MassHealth members and providers related to billing and policy, and claims. Also responsible for tracking lifecycle of each task, as well as maintain and update detailed reporting.
- Responsible for creation and maintenance of both ad-hoc and numerous daily, weekly, monthly, quarterly and yearly reports, as well as completing Quality Control reporting within Suspect Duplicate team.
- Act as subject matter expert on wide array of material, divvy claims review among team and conduct quality-control review of worked claims to ensure accuracy within department.
- Update and write new work instructions as well as policy and procedures for department during any policy and/or operational changes.
- Assist unit director and manager as needed with complex claim-adjudication and research projects. Undertake responsibility of unit manager during peak workload times or when out of office.
- Working alongside Program Managers of over one hundred Provider Types in order to provide resolutions to claims brought into question, while also serving as Project Manager and Technical Support throughout new initiatives.
- Review claims in Medicaid Management Information System (MMIS) that are in suspected duplicate status, while making decisions to pay, deny, resubmit, adjust, or void accordingly. Also responsible for keying these decisions into MMIS.
- Reprocess claim denials resulting from incident tickets or other sources, while monitoring results of reprocessing, while also reviewing suspended claims that pertain to systems errors and adjudicate correctly.
Operations Analyst
MAXIMUS
11.2014 - 05.2018
- Partnered with federal, state and local governments to make MassHealth insurance programs run more effectively for all members and providers; maintaining extensive working knowledge of broad spectrum of functional areas.
- Key member of Project Management Office supporting data management, client reporting, process engineering, quality control, and problem resolution.
Independently develops and implements modeling and evaluation processes to determine effectiveness of current operational activities.
- Conducts statistical analysis and evaluates wide variety of information to assess operational difficulties and develops solutions to complex and escalated issues.
- Design and implement process improvements that enhance customer and client services, while optimizing business operational efficiency and quality.
- Creates, analyzes, and delivers customized reporting for both internal and external audiences; while developing high-quality communications as team’s critical client interface.
- Acquire deep knowledge of working systems and bring efficient and effective changes for better performance across each project.
- Work closely with operations staff to define requirements, test criteria, and identify success factors, while also being responsible for writing all internal and external project change requests.
- Overseeing Correspondence and Action Request Tracking System for all client-escalated inquiries and issues regarding both MassHealth members and providers related to: enrollments, coverage, eligibility, billing and policy, claims, complaints, fulfillment, documentation, etc.
- Developing and overseeing plans for short-term and long-term projects, while working alongside other Project Managers, Coordinators, and other departments to ensure tasks are completed on-time in effective and efficient manner.
- Overseeing Software Development and Reporting team’s day to day activities, while determining weekly priorities and writing all business requirements for all internal and external development and reporting changes.
Owner & Manager
Rhode Island Independent Amateur Baseball League
01.2014 - 01.2018
- Franchise Owner and Manager for The Rhode Island Warriors, semi-professional baseball team part of the RIIABL. The Warriors consist of young and highly talented baseball players from all over the New England and Tri-state.
- Managing payroll and expenses, hiring coaching staff, planning all fundraiser and league events, acquiring sponsors to help fund team, creating and maintaining team brand, and purchasing all necessary equipment, uniforms and player's insurance.
Attend League Board of Director meetings to enhance all league policies and rules, as well as working with other managers to develop schedule for season, while working alongside City Representatives to discuss and develop permit contracts for all field use.
- Responsible for organizing filming of games with play by play announcer/color commentator; working alongside with local TV stations to have it reviewed, edited and aired.
- Maintaining team's Social Media pages and league website - giving updates to all fans on players, game outcomes, box scores, standings, major events, pictures, videos, etc.
- Take on all responsibilities being head coach such as scouting talent, organizing and holding all practices and tryouts, while developing rosters, depth charts, lineups, game-time strategies, as well as strength, conditioning and nutrition plans.
- Also starting player since 2014 season.
Founder & Head Consultant
Roberto Consilium
11.2013 - 01.2015
- Providing top notch business solutions through "best practice" approaches for each and every industry – making immediate contributions towards a company's strategic business objectives.
- Engaging in multi-source assessments in order to establish strong presence within company and using newly developed analysis model, to study each case in methodical and organized manner.
- Working alongside start-up ventures writing all business and marketing plans, while ensuring operations and supply chain management are being fully optimized.
- Responsible for hiring of employees, creating and maintaining website, as well as managing firm’s budget and assets.
- Key Projects:
John Hancock: Improvements were made to Information Technology Department’s relationship between John Hancock’s upper-management, their subordinates, and clientele – with overall goal of improving future successes in portfolio management. Primary and secondary research were conducted regarding insurance industry, history and effectiveness of using collaborative tools, and analyzing available tools in market – comparing results to technology being used.
- Netflix: Looking at issues Netflix faced after their services were split into two subscriptions, which ultimately led to loss of great deal of subscribers. Recommendations were made using competitive analysis with their main competition within market, as well historic look of market in past, as well as future.
- King Fish Media: CEO Cam Brown was consulted to improve all technological resources being used (Smartphone Application, Website, and Social Media Tools), as well overall advertising for company – in attempt to increase brand recognition.
Deposit Operations Representative
Peoples Federal Savings Bank
04.2013 - 05.2014
- Serve as one of main Customer Service Representatives for all branches: answering customer inquiries regarding their account in general or transaction history, offer technical support, and respond to all fraud posted onto their accounts
- Create notes on accounts for future references, process all travel notifications, and maintain all MasterCard fraud blocks.
- Research accounts and gather information in response to any legal subpoena’s that are issued upon customer or via customer request, and fill out "Verification of Assets" forms requested by outside Mortgage, Loan, and/or Housing companies.
- Project: In response to auditor requests, implementations were developed in order to maintain logging daily withdrawal limit changes, returned mail, and card transaction history.
Bank Teller
Peoples Federal Savings Bank
06.2012 - 04.2013
- Process all cash transactions, loan and mortgage payments, balance currency, cash and balance checks, prepare bank checks and money orders, exchange foreign currency, input payroll into system, process wires, and answer all banking inquiries.
Project: Working alongside Branch Manager/Assistant Vice President, new protocols were implemented revolving around content, brand clarity, and user experience of in-house advertising of bank branches.
Education
Bachelor Of Science In Business Administration - Management Major, Legal Studies Minor
Suffolk University
Boston, MA05.2014
College Preparatory Examination High School -
Boston Latin Academy
Boston, MA05.2010
Skills
- Resilient, resourceful, and solutions-oriented with ability to maintain positive attitude
- Experienced team leader with capability to manage and collaborate with large group of individuals
- Excellent analytical thinking, decision making and problem solving skills
- Strong strategic planning, execution and organizational skills
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Quote
Never forget where you came from or happiness will never be an attainable future.
Timeline
Founder
TCG-JC
04.2019 - Current
Program Coordinator II
Executive Office Of Health & Human Services
05.2018 - Current
Operations Analyst
MAXIMUS
11.2014 - 05.2018
Owner & Manager
Rhode Island Independent Amateur Baseball League
01.2014 - 01.2018
Founder & Head Consultant
Roberto Consilium
11.2013 - 01.2015
Deposit Operations Representative
Peoples Federal Savings Bank
04.2013 - 05.2014
Bank Teller
Peoples Federal Savings Bank
06.2012 - 04.2013
Bachelor Of Science In Business Administration - Management Major, Legal Studies Minor
Suffolk University
College Preparatory Examination High School -
Boston Latin Academy