Data Analytics Sas Developer
Resume:
Jacob D. Serbonich
**** ******** **** **., *******, MD 21076
********@***.***
Statistician and SAS Developer
CORE COMPETENCIES
t Statistical Analysis t Data Mining t Model and Algorithm Development t Hypothesis Testing t Trend Analysis t Sampling t Outlier Detection t Distributional Analysis t Database/Data Management t Extract, Transform, and Load t Data Visualization t Data Manipulation/Cleaning
SOFTWARE, PROGRAMMING, AND ENVIRONMENTAL COMPETENCIES
t Base SAS t SAS Enterprise Guide t SAS Enterprise Miner t SQL t Business Objects t RAT-STATs t Quest Analytics Software t OnePI/Integrated Data Repository t Fraud Prevention System t Data Analytics Studio t Chronic Conditions Warehouse t Microsoft Office Package t Teradata t Snowflake
EXPERIENCE
PURISOLVE INC. (SafeGuard Services), Remote. 2021 - Current
Statistician and SAS Developer on the Unified Program Integrity Contract (UPIC) for The Centers for Medicare and Medicaid Services. Supports the development of complex fraud, waste, and abuse models and algorithms and program integrity investigative cases that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for referral to law enforcement, recoupment of overpayment, and/or administrative actions. Member of the Intelligence and Special Interest Group (ISIG), which is responsible for brainstorming new schemes/proofs of concept, extracting, and analyzing data from the CMS IDR, and performing risk-reward analysis with respect to the outcomes of Fraud Prevention System (FPS) models.
tDevelops algorithms and models, creates outlier detection calculations and visualizations, and utilizes a wide array of statistical techniques used to identify aberrant patterns and trends that may be deemed cases of fraud, waste, and abuse across Medicare and Medicaid data claims, as well as provider, beneficiary, and geographic databases.
tProficient in big data analysis and manipulation via multiple, complex databases (data collection, data cleaning, data integration, data/variable transformation, data merging, advanced analytical techniques).
tExtensive experience utilizing packages such as Base SAS, SAS Enterprise Guide, SAS Enterprise Miner, SAS Web Studio, SQL, Business Objects, Data Analytics Studio, Zeppelin
tAdept in planning and implementing a plethora of sampling techniques, considering precision, accuracy, and the client’s requests, for purposes of generalization and extrapolation.
HEALTH SERVICES ADVISORY GROUP, Remote. 2020 – 2021
Lead Analyst and SAS Developer on the State Medicaid Encounter Data Validation, Provider Data Validation, Waiver Evaluation, and Network Adequacy Validation projects for Iowa, New Hampshire, New Mexico, Nevada, Oregon, and Utah.
tPerformed comparative analysis to evaluate the extent to which data submitted to state Medicaid agencies by health plans are complete and accurate, based on corresponding information stored in the health plans’ data systems. Computed several standardized metrics used to assess the degree to which health plans and states’ Medicaid encounter data are consistent.
tAssessed the capacity of a given MCO’s or DBA’s provider network by calculating member-to-provider ratios (provider ratio) and evaluates the geographic distribution of providers relative to Medicaid enrollees by performing geographic analyses by way of calculating the average time and distance an enrollee must travel to the nearest three providers.
tEvaluated Section 1115 Waiver programs by calculating rates from Medicaid claims data using a variety of specifications, including HEDIS and CMS core measure specifications, and custom specifications. Statistical analyses include simple descriptive statistics, difference-in-differences (DiD) with complex non-inferiority hypothesis testing, hierarchical regressions, and interrupted time-series.
tProvided the sampling methodology, analysis plans, calculations, and SAS programs necessary to pull stratified random samples for the Provider Data Validation project.
tParticipated as part of a coalition tasked with the redesign and implementation of a revamped hospital pay-for-performance for the state of Hawai’i. Tasked with researching and recommending performance measures and payment structures to be adopted by the Hospital Association of Hawai’i.
tInvolved in creating the initial New Employee Engagement Team which aimed to actively engage new employees for means of providing institutional knowledge, project and technical expertise, and mentorship.
ANALYTICA INC., Bethesda, MD. 2014 – 2020
Lead Statistician and SAS Developer on the Program Integrity Modeling and Analytic Support Contract (PIMASC), Unified Program Integrity Contract (UPIC), and the Zone Program Integrity Contract (ZPIC) for The Centers for Medicare and Medicaid Services. Supports the development of complex Fraud Prevention System models and algorithms and program integrity investigative 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.
tDeveloped algorithms and models, created outlier detection calculations and visualizations, and utilizes a wide array of statistical techniques used to identify aberrant patterns and trends that may be deemed cases of fraud, waste, and abuse across Medicare and Medicaid data claims, as well as provider, beneficiary, and geographic databases.
tProficient in big data analysis and manipulation via multiple, complex databases (data collection, data cleaning, data integration, data/variable transformation, data merging, advanced analytical techniques)
tExtensive experience utilizing packages such as Base SAS, SAS Enterprise Guide, SAS Enterprise Miner, SAS Web Studio, SQL, Business Objects, Data Analytics Studio, Zeppelin
tAdept in planning and implementing a plethora of sampling techniques, considering precision, accuracy, and the client’s requests, for purposes of generalization and extrapolation.
tEvaluated the effectiveness of FPS2 Models and the quality of generated leads by applying statistical techniques and advanced SAS programming scripts.
tResponsible for identifying new program vulnerabilities and participating in Model Discovery activities to develop new edits or FPS2 models.
tAssessed the completeness and accuracy of T-MSIS data by constructing sophisticated SAS programs designed to produce automated appraisals of several pre-defined data elements.
tAuthored and developed data management plans, statistical analysis plans, sample size plans and calculation spreadsheets (SVRS and purposive), and numerous program integrity referrals and analysis conclusion reports
IMPAQ INTERNATIONAL, Columbia, MD. 2011 – 2014
Served as a Statistician and SAS Programmer on the Bundled Payments Care Initiative Model 1 Project, Development of Medicare Advantage Prescription Drug Plan Monitoring Methods Project, Antipsychotic Use Among Medicaid Children in Eight States Project, Beneficiary Payment Validation Project, Evaluation of Medicare Part C and Part D Plan Sponsors’ Customer Service and Pharmacy Call Centers, Comparative Effectiveness Research Public Use Data Pilot Project, Evaluation of the Acute Care Episode Demonstration project and Payment Error Related to Prescription Drug Event Data Validation Project for The Centers for Medicare and Medicaid Services.
tUtilized advanced quantitative techniques to evaluate the effectiveness of government programs in a variety of settings.
tProcessed and evaluated Medicare and Medicaid data, including Part A claims, Part B claims, Part D claims, DME claims, beneficiary, provider, enrollment, and geographic data, and MSIS data.
tProduced and designed sampling specifications, analysis plans, provided probability calculations, calculated monitoring measures, computed sample size calculations and determinations, conducted hypotheses testing, executed distributional analyses and statistical tests of significance, carried out parametric and non-parametric regression analyses and modeling activities, and provided overall guidance regarding statistical methods.
tUtilized a wide array of SAS statements and procedures to formulate advanced outputs and gather, clean, manipulate, and generate analytical research files pulled from various sources and databases.
tNavigated such environments as the CMS Mainframe, Chronic Conditions Warehouse, Health Plan Management System, and the Integrated Data Repository
tMaintained structure of project folders and documents, location of all raw and formulated data files and developed and edited programs to ensure data organization and integrity.
tServed as Task Manager on the Development of Medicare Advantage Prescription Drug Plan Monitoring Methods Project and the Development of the Risk Adjustment Data Validation (RADV) Standard Operating Procedures
BOOZ ALLEN HAMILTON, Rockville, MD. 2010 – 2011
Served as a skilled Statistician and Health Care Analyst on the Payment Error related to Part D Benefit Administration and Direct and Indirect Remuneration projects. Provided sound statistical advice and techniques in developing analysis and sampling plans, manipulation and formulation of analytic files pulled from a variety of databases, and analyses of prescription drug event and beneficiary enrollment data using SAS and other statistical software packages.
tApplied statistical techniques to reduce payment errors by analyzing Prescription Drug Event data, beneficiary-level data, and prescription drug and pharmacy-level databases.
tParticipated in developing sampling plans, statistical methodologies, and extrapolation procedures to produce a composite error rate.
tResponsible for risk mitigation plans, data verification and manipulation, data security, outlier detection and a thorough understanding of CMS’ mainframe systems.
tProduced distributional analyses, descriptive statistics, and significance tests to check for overall sample representativeness.
tConducted instructional meetings with team members regarding management and transferring of large data sets between databases.
tUtilized statistical packages such as SAS and Microsoft Excel to conduct daily analyses.
EDUCATION AND AFFILLIATIONS
Master of Science, Biostatistics, George Washington University, Washington, D.C., 2010
Bachelor of Science, Pre-Medicine, Syracuse University, Syracuse, NY, 2005
Certifications
tSAS Base Certification
tExcel with Business
tData Science Specialization (Currently Pursuing)
Trainings
tExcel with Business
tSAS Enterprise Business Intelligence (SAS/EBI) Training
tIntegrated Data Repository (IDR) Overview and Data Analytics Training
tDiagnosis-Related Group Analysis Training
tSpeech-Language Pathology Analysis Training for Data Analysis
tSAS Tips and Tricks for Analyzing Medicare Claims
tProvider Time and Travel Interactive Mapping Training
tIdentifying Providers as Outliers and Targets
tWashington Statistical Society - Bureau of Labor Statistics- Programming with R
tWashington Statistical Society at Bureau of Labor Statistics - Complex Survey Design and Analysis Techniques
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