Kenneth Vandermark Jr
Hawley,PA
Summary
I own my own Mobile Disc Jockey/Photobooth business for over 30 years with a successful entertainment business that has received a high number of 5-star ratings on several different platforms to include wedding websites, social media platforms, content marketing, and branding. Utilization of social media to include creating events, marketing posts, creating reels, and utilization of social media analytic tools to track customer engagement-satisfaction.
Overview
27
27
years of professional experience
Work History
Medical Management Specialist II (WAH/REMOTE)
Elevance Health
04.2022 - Current
- Company Overview: Carelon Behavioral Health-Middletown, NY
- Scheduling and assist in multiple markets with Medical/Behavioral Providers
- Gather clinical information regarding cases and determine appropriate areas to refer to or assign (Utilization Management, Med Review)
- Provides information regarding network providers or general information when requested
- Assists with complex cases
- Liaison between Case/Medical Management and/or Operations and Internal departments
- Maintains and updates tracking databases
- Prepare reports and documents for all actions
- Responsibilities include conducting any utilization management review activities requiring clinical information interpretation
- Carelon Behavioral Health-Middletown, NY
Plan to Plan Service Representative II (WAH/REMOTE)
Anthem BCBS/Wellpoint Inc.
01.2017 - 04.2022
- Company Overview: Middletown, NY
- (Work From Home) Telephone Correspondence to include; Blue Cross Plan to Plan Customer Service, Benefit Quotes, Review/Investigation, Adjustments, Advocacy, Training, Claims Processing, Adjustments, Routing Medical Records for Clinical Review, Inventory Timelines for Current and Existing Accounts, Expected Reports, Coordination Of Benefits, and Updates for No Fault/Workman's Compensation
- Middletown, NY
- Successfully maintained Meeting Expectations or Above
- Have many Member/Customer Accreditation
- I was cross trained in systems to complete Claims Processing, Edits, and Adjustments, as well as part of a Selective Inventory Team
Customer Service Rep III (WAH/REMOTE)
EMPIRE BLUE CROSS BLUE SHIELD/ANTHEM
08.2006 - 01.2017
- Company Overview: Middletown, NY
- Telephone Correspondence -Members, Providers, Medical Management, BCBS Plans
- Cross Trained Claims/Adjustments
- Worked with Management to resolve higher escalated issues within the Team
- Middletown, NY
Assistant Store Manager
Sears
06.2005 - 07.2006
- Company Overview: Middletown, NY
- Customer Service, Scheduling, Interviewing, Manage (25-30) Employees, Sales, Merchandise Layouts, Associate Development, Policies & Procedures, Corporate Goals to include; Sales, Protection Agreements, Merchandise Agreements, and Inventory Control/Shrinkage, and Conduct Store/Departmental Meetings
- Middletown, NY
- Successfully reduced department Shrinkage from $450,000 loss to under 1.0%
- Increase Associate Awareness, Cleanliness, and Increased Merchandise/Protection Agreement Goals
Store Manager
Dollar General
12.2003 - 06.2005
- Company Overview: Ellenville, NY
- Customer Service, Merchandise Layouts, Scheduling, Payroll, Sales, Profit & Loss, On hand Stock Inventory and Product Replenishment, Inventory Control, Vendor Contacts/Distribution, Training, Deposits, Conduct Associate Meetings and Regional Meetings, and Assist New Opening/Remodel Stores
- Ellenville, NY
- Reduced Shrinkage and moved to higher Volume Store
- Assisted with District Meetings/Training
Loss Prevention/Operations Manager
Neiman Marcus
08.1998 - 12.2003
- Company Overview: Monroe, NY
- Security Manager/Operation duties to include Store/Company Asset Protection, Scheduling, Training, Sales, Markdowns, Reports, Purchase Order Approval, In Store Petty Cash Disbursement, Store Operational Orders/Replenishment, Associate Incentive Programs, Protect our Profits Programs, Inventory/Sales Goals, Department/Store Meetings, and Personal Customer Service
- Monroe, NY
- Successfully Recognized for winning the best Associate Awareness Presentation for 'Protecting our Profits' to Store Associates 3 out of 5 times within my Career
- Maintained Consistent Company Goals in Asset Protection and Inventory
Education
High School Diploma -
North Central High School
Spokane, WA06-1988
Skills
- Customer service
- Microsoft Office/365 (Word, Excel, Powerpoint)
- Interviewing
- Account Management
- Leadership/Coaching/Training
- Organization/Attention to detail
- Profit & Loss
- Store Management Experience
Timeline
Medical Management Specialist II (WAH/REMOTE)
Elevance Health
04.2022 - Current
Plan to Plan Service Representative II (WAH/REMOTE)
Anthem BCBS/Wellpoint Inc.
01.2017 - 04.2022
Customer Service Rep III (WAH/REMOTE)
EMPIRE BLUE CROSS BLUE SHIELD/ANTHEM
08.2006 - 01.2017
Assistant Store Manager
Sears
06.2005 - 07.2006
Store Manager
Dollar General
12.2003 - 06.2005
Loss Prevention/Operations Manager
Neiman Marcus
08.1998 - 12.2003
High School Diploma -
North Central High School
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