John is a Principal Industry Consultant at SAS, and former State Medicaid Program Integrity Director, with nearly 25 years in state government. As part of the SAS Global Fraud practice, he supports private and federal/state public healthcare and other government social benefit programs worldwide. John has a BA in Business and holds CPA, CFE, and AHFI designations.
Imagine for a moment: You’re a single parent working to make ends meet as you balance rent, bills and the cost of living. Add on losing your job. Then, food assistance and health care access become incredibly important to your family. Millions of households receive social safety benefits. In the
Medicaid program integrity, in simple terms, is a program that ensures that the funds allocated for Medicaid are used appropriately, that patients receive the care they deserve and that resources aren’t mishandled. But consider this staggering fact: In 2020, the Centers for Medicare and Medicaid Services (CMS) reported that Medicaid
My favorite tech influencers teach, ask questions and share their knowledge freely. They value quality over quantity, and they engage with each other authentically. My goals on social media are to learn, engage with the world socially, and to share what I think is cool – sometimes this is about
Data-driven is a buzzword again. It feels new and shiny but has been around for years. Yet, people still ask what it means to be data-driven. If you wonder why it’s important to be data-driven, you might ask your bookie. Yes, I said your bookie. In thinking about when I
The data revolution is causing disruption everywhere. Even governments are feeling the effects. While the public sector may be less prepared for the impending changes, government has good reasons to embrace the data revolution. First, governments have been collecting data for years. They have lots of data. This supports programs,
SAS was again named a Top 10 Place to Work in the World by Great Places to Work™. This is quite an honor, and one which SAS has enjoyed for the past eight years. SAS has also been a highly ranked work place in the US for the past 20
Artificial intelligence often seems misunderstood, especially in fraud. The same is true of machine learning. One of the amazing things about them is they ask the unasked questions. This occurs as artificial intelligence (AI) and machine learning (ML) go about their daily work. So, what is the unasked question? Too
Nothing says you are wasting your time and energy more than referring to a process as plowing a field with a fork. I liked to use this phrase as a manager and auditor, especially in government. Good data analytics makes a big difference in problem solving. Does anyone think a
I am unabashedly a data zealot, but not a data scientist. I believe in the power of data and data analytics, and that the data revolution has started. It will transform all our lives in ways we cannot even imagine. This is one of the things that attracted me to
Soccer has been on my mind since the recent tournament in Russia, and fraud is always on my mind. Fighting fraud today means thinking about artificial intelligence (AI) and machine learning (ML). Everyone says so. Like me, you probably wonder how AI and ML work – especially in fraud. What
