John B. Email & Phone Number

1390 Timberlake Manor Suite 450

Chesterfield, Missouri

Investigate allegations of potential Medicaid and Medicare fraud, waste, and abuse via prepayment review and retrospective investigations. Refer fraud and abuse to appropriate state and federal agencies. Conduct audits. Perform data mining and analysis to detect aberrancies and outliers. Advise mentees on varies issues related to an investigation. Assist with "One on One" training with new employees. Coordination with Health Plans on recommendations and further actions needed. Prepare summary and/ or detailed reports on investigative findings. Develop new queries in order to detect potential fraud, waste, and abuse. Ensure compliance with Centers for Medicare and Medicaid Services (CMS), State agency, Health Plan's Anti-Fraud Plan, and Federal and State rules and regulations. Complete monthly, quarterly, ad hoc, and health plan reporting in a timely and accurately in accordance with state contractual requirements. Request medical and pharmacy data queries utilizing Microstrategy and Health Care Fraud Shield.

United States

Investigate drug distribution. Team Lead. Work with Federal and State agency to identify drug traffickers. Conduct undercover narcotic buys. Manage confidential informants. Prepare search warrants and present the warrants to the Prosecuting Attorney's Office. Write detailed investigative reports. Assist with training new Detectives assigned to the unit. Preserve law and order, to prevent and discover the commission of a crime. Gather evidence, obtain witnesses, make arrest, and testify as a witness in a court of law. Interviewing alleged suspects and victims.

Saint Louis, Missouri

Work as the Legislative body of the city. Responsible for conducting monthly meetings to discuss and address city business. Assist with balancing of the budget. Adopt legislature/city ordinances. Responsible for making decisions as it related to personnel. Chairman of Legislative Committees

Greater St. Louis Area

Investigated allegations of child abuse and neglect. Conduct home visits to ensure child safety. Wrote court affidavits and prepared formal documentation to the Family Courts. Wrote detail reports regarding findings/results of investigation. Interviewed alleged victims and suspects. Appeared and testified in court hearings. Located appropriate housing for abused and neglected children. Worked and made referrals to local Law Enforcement.