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Advanced analytics are
changing the way health care enterprises detect and prevent fraud.
Discover how Social Network Analytics can enhance traditional
predictive modeling capabilities.
Join Bill Fox, JD, MA,
Senior Director Health Care, LexisNexis Risk Solutions and Jo
Prichard, Consulting Software Engineer, Lexis Nexis Risk Solutions as they guide
you in understanding how this technology combined with claims and
public data can help payers uncover complex and hidden collusion
across their plan.
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Participants will be able to:
- Understand how to harness, integrate and query “big data” to
build graphs that leverage the power of linking to reveal hidden
relationships between providers and recipients and identify
suspect claims patterns that rules based systems miss
- Learn how to identify fraud proactively using cutting edge
predictive and social network analytics
- Explore case study results to determine: what does social
network analytics truly tell us?
- Engage in interactive learning through online question submission, attendee feedback and opportunity for
follow up questions, and networking with attendees, faculty and other
professionals through dedicated LinkedIn group
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Interested attendees would
include:
- C-Suite Executives
- Fraud & Abuse Prevention and Recovery Executives and Staff
- Finance Executives
- Claims Unit Executives and Staff
- Analytics and Informatics Executives and Staff
- Actuarial and Underwriting Executives and Staff
- Statisticians and Data Analysts
- Planning and Strategic
Executives and Staff
- Health Benefit Managers
- Business
Intelligence Staff
- Health Care Economists
- Other Interested Parties
Attendees would
represent organizations including:
- Health Plans
- Provider Networks
- PBMs
- Employers
- Third Party Administrators
- Government
- Business Process Organizations
- Solutions Providers
- Consulting Organizations
- Associations, Institutes and
Research Organizations
- Media
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Registration is Complimentary for qualified applicants.
Applications will be accepted by the Summit sponsor according to
their criteria. Applicants approved for registration will be
notified by Summit within approximately seven business days of
application or sooner.
Registration has now closed
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Bill Fox, JD, MA
Senior Director Health Care, LexisNexis Risk Solutions
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Bill Fox, JD, MA, is Senior Director of Health Care at LexisNexis Risk
Solutions. Prior to LexisNexis, Mr. Fox was Vice President of Program
Integrity at MAXIMUS Federal. He was a Partner at the law firm of Post
and Schell, and was Deputy Chief of Economic and Cyber Crime at the
Philadelphia District Attorney’s office and a Special Assistant U.S.
Attorney in Philadelphia.
Mr. Fox is a Senior Fellow at the Jefferson School of Population
Health in Philadelphia and a frequent speaker on topics of health care
fraud, compliance and quality. He has also served as a tactical strength
and conditioning consultant to the U.S. Navy SEALs.
LexisNexis Risk Health Care Solutions develops and implements
innovative data driven technology solutions across the health care
continuum with a focus on identity management/HIE, predictive analytics,
fraud, waste and abuse detection and prevention, and disease management.
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Jo Prichard
Consulting Software
Engineer, LexisNexis Risk Solutions
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Mr. Prichard is a consulting software engineer at
LexisNexis Risk Solutions. He has responsibilities to the
core HPCC Systems platform technology. He spearheads large
scale graph analytics projects working with big data, for
various industries to help customers target fraud, collusion
and other red flag indicates.
Prior to LexisNexis,
Mr. Prichard worked for Topspeed Software R&D in London and
was a conference speaker on various aspects of the Clarion
programming language. He also worked for the largest
insurance company in South Africa to create systems to help
customers receive immediate insurance quotes.
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