Michael Tabor Email & Phone Number

Jacksonville, Florida Area

UPIC Midwest contract acquired by CoventBridge Group. No change in job responsibilities.

Grove City, Oh

Perform in-depth evaluation and analysis of potential fraud cases and requests for information using a universe of over 20 billion rows of healthcare claims data, enrollment files, and third party dataAssess any limitations of the data, in terms of reliability or usability, resolve issues and propose work around methodologies where applicableIntegrate publicly available data with the in-house environment such as state licensures, beneficiary contacts, and ICD CPT/DX code… Show more Perform in-depth evaluation and analysis of potential fraud cases and requests for information using a universe of over 20 billion rows of healthcare claims data, enrollment files, and third party dataAssess any limitations of the data, in terms of reliability or usability, resolve issues and propose work around methodologies where applicableIntegrate publicly available data with the in-house environment such as state licensures, beneficiary contacts, and ICD CPT/DX code labelingDevelop, validate and review data analysis reports to identify violations of laws, guidelines, policies, regulations and potential program vulnerabilitiesResearch data fields, policies and other relevant information to ensure that the most appropriate techniques and/or methods are utilizedSupport the development of complex cases that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for referral to law enforcement, recoupment of overpayment, and/or administrative action based on reactive and proactive data analysisCommunicate effectively with management, investigators, analysts, other Statisticians, as well as internal and external clients to provide reactive and proactive data analysis supportCreate Excel-based tools utilizing SAS scripts in order to allow PI Analysts not familiar with SAS to perform common data analysis tasksPresent complex analytic approaches and results to a non-data savvy audience including representatives of the FBI, DOJ, OIG and CMS Show less

Greater Nashville Area, Tn

Provide oversight, supervision, training and development of data analysts, senior data analysts and statisticians in performing complex cross claims analysis for Medicare and/or Medicaid benefitsCoordinate data analysis/statistical analysis activities for and liaise with internal and external stakeholders, including law enforcement and CMSEnsure compliance with PIM guidelines and CMS direction concerning data analysis and data managementAct as a custodian of records and… Show more Provide oversight, supervision, training and development of data analysts, senior data analysts and statisticians in performing complex cross claims analysis for Medicare and/or Medicaid benefitsCoordinate data analysis/statistical analysis activities for and liaise with internal and external stakeholders, including law enforcement and CMSEnsure compliance with PIM guidelines and CMS direction concerning data analysis and data managementAct as a custodian of records and certify deliverablesTestify to claims data, analyses and CMS claims processing methodologies in both civil and criminal healthcare fraud trial settingsHire and provide guidance for data analysts, senior data analysts and statistical staff through one-on-one and classroom training environmentsProvide overall direction for the data analysis unit including assignment and monitoring of workload, adhering to established deadlines, priorities and standards and identifying potential process improvement measuresDevelop and present training on AdvanceMed’s data analysis capabilities to both internal staff and law enforcement healthcare fraud workgroupsEmphasize the utmost importance and best practices of handling Controlled Unclassified Information (CUI), specifically PHI and PII Show less

Greater Nashville Area, Tn

Perform in-depth evaluation and analysis of potential fraud cases and requests for information using a universe of over 20 billion rows of healthcare claims data, enrollment files, and third party dataAssess any limitations of the data, in terms of reliability or usability, resolve issues and propose work around methodologies where applicableIntegrate publicly available data with the in-house environment such as state licensures, beneficiary contacts, and ICD CPT/DX code… Show more Perform in-depth evaluation and analysis of potential fraud cases and requests for information using a universe of over 20 billion rows of healthcare claims data, enrollment files, and third party dataAssess any limitations of the data, in terms of reliability or usability, resolve issues and propose work around methodologies where applicableIntegrate publicly available data with the in-house environment such as state licensures, beneficiary contacts, and ICD CPT/DX code labelingDevelop, validate and review data analysis reports to identify violations of laws, guidelines, policies, regulations and potential program vulnerabilitiesResearch data fields, policies and other relevant information to ensure that the most appropriate techniques and/or methods are utilizedSupport the development of complex cases that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for referral to law enforcement, recoupment of overpayment, and/or administrative action based on reactive and proactive data analysisCommunicate effectively with management, investigators, analysts, other Statisticians, as well as internal and external clients to provide reactive and proactive data analysis supportCreate Excel-based tools utilizing SAS scripts in order to allow PI Analysts not familiar with SAS to perform common data analysis tasksPresent complex analytic approaches and results to a non-data savvy audience including representatives of the FBI, DOJ, OIG and CMS Show less

Supervise the daily operation of the Transportation Section of the Transitional Work Program and fourteen transport officers.Coordinate the daily transportation of 175+ inmate workers to over 35 locations across four parishes.Maintain effective lines of communication with businesses utilizing Transitional Work Program services.

First-line supervisor of facility operations for the Transitional Work Program.Address the concerns of businesses utilizing Transitional Work Program personnel as they arise.Maintain inmate database and generate various reports.

Maintained the safety and security of the Transitional Work Program.Utilized inmate database to generate reports and queries.

Master Of Science (M.S.), Mathematical Statistics

Bachelor Of Science (B.S.), Mathematics

Activities and Societies: Phi Mu Alpha Sinfonia