Brian Simonson Email & Phone Number

Falls Church, Va, Us

Buffalo, New York, United States

Buffalo, New York, United States

Mr. Simonson leads program integrity analytics capabilities for The Lewin Group. Additionally, he applies his expertise of survey sampling theory throughout the firm. Recent projects include:For Centers for Medicare and Medicaid Services (CMS), led the development of a machine learning predictive framework that identified high and low performing providers in the areas of Fraud, Waste, and Abuse.For CMS, evaluated the effectiveness of numerous program integrity efforts performed by CMS. This analysis provided CMS with a measure of return on investment for these activities. Efforts measured include Recovery Audit activities, Clinical Billing Reports, PEPPER Reporting, prior authorizations, and complex medical prepay review activities.For CMS, serves as Chief Statistician in the Comprehensive Error Rate Testing (CERT) program and the Payment Error Rate Measurement (PERM) program which measure improper payments for Medicare and Medicaid, respectively.For Ingenix, constructed an sampling and estimation design for measuring improper billing patterns from healthcare providers. The design optimized the number of claims to review from each physician so as to maximize return on invesment.For Ingenix, forecasts healthcare expenditures for healthcare insurers. Using time series forecasting techniques, produce estimates that predict the trend of costs for healthcare insurers.For Society of Nurse Anesthetists, constructed staffing model that simulated the costs associated with various care settings. The model measured the cost efficiencies of care settings with different nurse anesthetists to anesthesiologist ratios.

M.S., Statistics

B.S., Economics