sascom voices - The sascom magazine blog

In addition to his AHIP membership, Rick has represented SAS in key industry gatherings including the Disease Management Association of America (DMAA), Healthcare Financial Management Association (HFMA), and National Health Care Anti-Fraud Association (NHCAA). In 2005, he served on the National Anti-Fraud Project Executive Committee for the Office of the National Coordinator for Health Information Technology (ONC), administered through the American Health Information Management Association (AHIMA). He also just completed service with the ONC’s Anti-Fraud Model Requirements Executive Team to develop an Anti-fraud Model for the subsequent ONC submission to the Healthcare Information Technology Standards Panel (HITSP).

Rick's previous positions include health delivery program management capacities within the Florida Department of Health & Rehabilitative Services, including Business Director for the Leon County Public Health Department in Tallahassee, Florida and the manager of an investigative unit with the Bureau of Allied Lines, Florida Department of Insurance in 1986.

Over the next eleven years, he worked as Director of Case Management and VP Operations, Controller, and Chief Financial Officer for Equicor (HCA & Equitable joint venture), CIGNA and the Health Services Group, respectively. In these roles, Rick directed numerous managed care program design and development initiatives as well as strategic acquisition projects. His knowledge of claims patterns and analysis for fraud detection was formed both via his DOI and Equicor posts. He presents expertise in risk stratification for disease and medical case management, medical utilization improvements, provider performance & quality benchmarking, process engineering, and internal control projects within the health insurance arena. At each stage of his career, Richard has been engaged in efforts to improve the method of information sharing and collaboration across the healthcare payer and provider sectors.

Since joining SAS in 1998, Rick’s efforts have been directed toward working with senior level management teams in the health care sector in their efforts to improve strategic decision making processes, knowledge management and aligning information technology capacities with business. Charged with setting the vision and aligning capacity for SAS’s contribution within healthcare, he has identified improving analytics for the shift to electronic medical records, the disease management process, detection & prevention of fraudulent claims, provider performance reporting & profiling, consumer driven health plan analytics and customer profitability intelligence as key SAS focus areas for this sector.