Project Manager Customer Service

James V. Ralston, PhD

***** *. **** ******, ******, KS 66219 abjglo@r.postjobfree.com

Home: 913-***-****

abjglo@r.postjobfree.com MobilePhone: 913-***-****

Systems and Operations Professional Operational Excellence through Process Design &

Automation

Extensive experience in national and global companies, with demonstrated success in delivering complex

integrated solutions on- time, on-budget and “on-specification”. Fluent in the languages of both business and IT. Keen

focus on stakeholder needs and business processes. Excellent communication skills. Thinks outside the box, but within

acceptable risk tolerance.

Areas of Areas of Expertise

Project Management (PMP Certified) Financial & Technology Industries Operations

Six Sigma (GE Six Sigma Black Belt) Metrics & Reporting Usability/Ergonomics

EXPERIENCE:

CROWE PARADIS SERVICES CORPORATION, North Reading, MA 2010 – Present

A fast growing leader in Medicare-related services for insurance companies.

Project Manager/Black Belt (2010-Present)

Led cross-functional teams to deliver solutions for reporting claims data to CMS (Center for Medicare and Medicaid

Services), as required under recent MMSEA S.111 legislation.

• Manage team of claims professionals and IT resources to implement systems and processes which convey claims information to

Center for Medicare and Medicaid Services. Develop project plans, host team meetings, manage project execution, conduct

training, create statistical reports, develop and execute communications plan.

• Lead process re-engineering project for Sales division. Manage project, Define existing and “to-be” processes, source and

configure CRM system to support processes, Implement new process and statistical process control reports.

SWISS RE, Overland Park, KS & Zurich, Switzerland 2006

– 2009

A global leader in reinsurance and insurance, with over $20B in earned premiums in fiscal 2008.

Project Manager (2008-2009)

Led cross-functional, global team through one major and 3 minor development cycles of a full-featured claims workflow

system, with aggregate +$3M budget. Worked with multiple stakeholders, utilized project management tools,

communicated with large groups and reported to management teamsActive in all phases of project management

lifecycle..

• Led development cycle in which the workflow system was directly integrated with transactional claims system and with

business partners’ transactional systems, utilizing state-of-the-art technologies and industry standards. The efficiencies

gained through process simplification and automation estimated at $1M – $2M per year.

• Led three smaller, but large, development cycles as Project Manager, while at the samesome times supporting in a variety of

other roles, including business analyst and testing manager.

Even these smaller releases were feature-rich, including expansion to support technical accounting, and a large variety of

other technical and functional enhancements.

Business Analyst (2006-2008)

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James V. Ralston, PhD

Key architect of several major releases and several minor releases of global claims workflow system. Analyzed business

needs, designed functional solutions, developed process and system specifications (i.e., use case, screen designs,

functional specifications), designed test cases, and managed testing.

• First generation release of the workflow was integrated with an electronic document system and data warehouse. The

workflow and associated scanning systems replaced antiquated paper-based processes, and, for the first time, provided:

statistical transparency for management, coordinated claims review by dispersed colleagues, outsourcing of clerical tasks,

and savings via physical paper storage, The benefits of the pervasive impacts of this system are at $1M - $3M per year.

GE INSURANCE SOLUTIONS, Overland Park, KS 2000 – 2006

A global leader in reinsurance and insurance, ultimately acquired by Swiss Re. Formerly known as ERC (Employers

Reinsurance Company).

.

Project Manager/Business Analyst (2003-2006)

Led global multi-functional team in development and deployment of highly integrated and diverse insurance claims

systems. Managed requirements collection, development of technical specification, implementation, testing, training, and

help desk support.Managed all phases of the project lifecycle, and active business analyst.

• Led development of both transactional claims system and integrated document workflow systems. The transactional claims

system replaced multiple legacy systems acquired through business acquisitions, and the workflow system replaced stand-

alone document repositories, or in many cases replaced paper-based processes. The new systems established process

unification and simplification, management transparency through statistical reports, direct access of documents, and

savings realized through out-sourcing and the elimination of support infrastructure for multiple systems.

Six Sigma Black Belt (2001-2003)

Applied Six Sigma methods to re-engineer business processes in a globaln insurance environmentcompany. Several

projects involved development of web-based workflows to process digitized documents. Mentored Green Belts, completed

related training (DFSS, Lean), and taught Green Belt classes.

• Created streamlined, digitized process for medical malpractice claims group, reducing processing time for initial claim

notices from +100 days to about 1 week. The reduction in processing time helped contain the size of payments for large-

dollar claims and reduced risk of “bad faith” claims against GE.

Manager, E-Business (2000-2001)

Built team, methods, and systems to develop and deliver a variety of innovative usage and business reports for E-

Commerce design and business management.

SPRINT PCS, Kansas City, MO 1996 – 2000

National wireless telecommunications company with over 20M subscribers.

Manager, Product Development & E-Business (1996-2000)

Developed wireless products and services, including retail kiosks, messaging and internet services, and billing design.

Built analytics team and infrastructure for E-Business and wireless services.

• Developed end-to-end reporting system for Sprintpcs.com, which included state-of-the-art hardware & software platform for

computations, data transport systems, and reporting layer. Included daily SMS text-based reports of sales and customer service

inquiries delivered to mobile phones of upper management. Formed and managed seven-person team of business and IT staff.

• Developed full-featured, functional web-based prototype of wireless services portal for consumer market. The prototype was

used as a model for sprintpcs.com, which was created two years later. The model was used for management demonstrations

and for usability & marketing studies, providing useful information that guided development of Sprintpcs.com.

EDUCATION:

• PhD, Psychology, State University of New York at Buffalo, Buffalo, NY

• BS, Psychology, Tulane University, New Orleans, LA

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James V. Ralston, PhD

15603 W. 81st Street, Lenexa, KS 66219 abjglo@r.postjobfree.com

Home: 913-***-****

abjglo@r.postjobfree.com MobilePhone: 913-***-****

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