Sponsored Webinars - Truven

Advanced Analytic Methods for Preventing and Detecting Fraud
Presented by Truven Health Analytics

Date: March 5, 2013
Time: 2:00 p.m. - 3:00 p.m. EST
CPE: 1

What works to prevent waste in the health care payer world? This webinar is designed to give listeners the practical tools they can put to use immediately in their own fraud detection efforts.

In this session we will focus on:

  1. Trends in the U.S. with a focus on analytics and predictive modeling technology
  2. Early stage detection and prevention to deter inappropriate billings
  3. Key algorithms and advanced methods that work

Join us as we provide meaningful insights into how analytics can improve efficiency and lead to better results.

Faculty Information

Jean MacQuarrie
Jean MacQuarrie is the Vice President, Payment Integrity Solutions at Truven Health Analytics, providing leadership for the development and deployment of payment integrity solutions. She has been with Truven Health since 1997. Ms. MacQuarrie is a nationally recognized fraud expert who has twice testified before Congress on this subject, most recently on April 5, 2011. She previously served as Vice President for our Federal business. Ms. MacQuarrie led the design team that developed the algorithms for fraud detection that are embedded in our analytic products and services. Ms. MacQuarrie holds a B.S. degree in Mathematics from the University of South Carolina.

Josh Ruminski
Josh Ruminski is a Director of Client Services where he is responsible for over a dozen clients and specializes in payment integrity solutions. He has deep policy and operational knowledge of the healthcare industry, specializing in the latest trends and information regarding program integrity (preventing fraud, waste and abuse) within Medicaid and Medicare. Prior to joining Truven Health Analytics, Mr. Ruminski was Deputy Director of Operations for Masshealth, the Massachusetts Medicaid program, where he created the MassHealth Operations Integrity Unit, which is responsible for reducing and preventing fraud, waste, and abuse in the Medicaid program. Their efforts saved the Commonwealth over 30 million dollars and included the creation of an IT infrastructure dedicated to program integrity.

David Nelson
David Nelson, Senior Director at Truven Health Analytics is responsible for market research and strategy. In this role, he works with state and federal agencies, partners, and industry leaders. Mr. Nelson also specifically focuses on strategy for the Truven Health program integrity solution for commercial and government markets. Prior to joining Truven Health, Mr. Nelson held leadership positions with The Advisory Board Company, Gemini Consulting, Blue Cross and Blue Shield of Massachusetts, and Henry Ford Health System. Mr. Nelson holds an M.S. from Harvard University and a B.A. from Michigan State University.