Yu Li Email & Phone Number

5850 Waterloo Road - Suite 140 Columbia Md 21045

- Conduct statistical analyses on correlations between the healthcare costs and the marketing practices of medical device and pharmaceutical companies. Build statistical computation models to study inference of healthcare providers’ industry interactions and their Medicare and Medicaid utilizations. Develop pilot statistical and machine learning data modeling by combining industry interactions, provider profiles, and Medicare cost patterns to identify outlier healthcare providers. These works have resulted in the establishment of two statistical models for identifying questionable providers that committed fraud, waste, and abuse in Medicare durable medical equipment (DME) services.- Provide expert input and guidance on statistical approaches and strategies, monitor healthcare cost trends and identify spikes and anomalies. Advise management on interpretation of results and present the data analytics to organizations within or outside. The statistical analysis has provided corroborating findings that resulted in federal administrative actions against fraudulent healthcare providers.- Design and oversee various operational data analyses to assess trends, quality parameters, and anomalies. Provide recommendations to senior management on how to enhance open payments data structures and to incorporate the datasets into analytics for the program integrity.- Review statistical and machine learning results generated by analytical contractors. Provide analytical advice to team members and the senior management. Collaborate with different teams to identify emerging vulnerabilities and provide recommendations on safeguarding Medicare and Medicaid trust fund.

1 W Pennsylvania Ave, Towson, Md 21204

• Designed, developed, and implemented predictive models to identify fraud, waste, and abuse on Medicare Part A, B,DME, and Part D claims saving millions of dollars for CMS and making the agency more efficient.• Technical lead advising ten team members on enhancement and conversion of 80 plus statistical fraud detection models into scalable data modelling platform ( PySpark/SparkR ).• Designed training programs, developed training materials, and delivered training sessions to statisticians and data analysts for fraud detection modelling across the nation.• Conducted studies and researched on machine learning algorithms and developed pilot machine learning models in Spark platform improving prediction accuracy and enhancing effectiveness of the fraud prevention system.• Collaborated and consulted with data scientists and senior management team to develop and implement machine learning algorithms assessing risk score of 300 plus fraud detection models and 25,000 plus alerted Part A, B, and DME providers. The project provides an automated method to prioritize the investigations on the alerts and evaluate the model performances.

111 Rockville Pike # 1000, Rockville, Md 20850

• Conducted quantitative analysis on insurance portfolios, developed prototypes for asset /liability management for insurance risk management. Interpreted and presented results to financial institutions. • Architected stochastic analysis building analytical data models to capture, analyze and statistically simulate market risk and credit risk exposures associated with energy commodity trading volatilities. • Collaborated with key team members to build automated data flow architect for reporting real-time profit/loss valuation of financial trading portfolios, the solution includes deal capture, financial instrument valuation, and end-user reporting. • Orchestrated design and development of auto regression framework reducing the test time for validation of complex statistical models such as potential future exposure (PFE) and Value at Risk (VaR) by 30% and effectively enhancing the SAS risk management solutions.• Analyzed business requirements from financial institutions, developed prototypes using SAS analytical software. Interpreted and presented results to clients with the goal to expand SAS financial service market.

Baltimore, Maryland Area

• Conducted quantitative analysis to calculate the cost of international coal and gas transportation deals and developed analytical tools for deal review and approval process. • Built forecasting models evaluating market risk of the energy trading portfolios, delivered market risk reports to front desk traders. • Consulted with risk management leadership team to develop and implement data models to capture credit risk measures, presented and interpreted the results to portfolio managers.

Deer Park, New York

• Played key role in providing thermal management analysis for micro-fluids devices.• Developed data-based models to analyze test data and identify failure patterns of micro-electronic devices.• Coordinated with electric engineers and operators to build microelectronic package prototypes resulting in winning multimillion-dollar subcontract for components of F22 fighter jets.

Ms, Finance, 3.7

Finance

Bs, Engineering, 3.9

Activities and Societies: Badminton, SwimmingBS in Mechanical Engineering

Master'S Degree, Mechanical Engineering, 3.7

Activities and Societies: ChorusMS in Mechanical Engineering