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Mark Ireland MA, StatisticsStreet Address  (734) 3830-0425 EMAIL AVAILABLEKEY COMPETENCIESStatistical experience designing and executing predictive models that optimize financial, risk, marketing, and healthcare initiatives. Increased sales by using market research tools such as segmentation, digital attribution, and key drivers of satisfaction using survey research techniques. Application of predictive models and time series models for financial forecasting in several industries. Statistical sampling of large data sets for audit and refund projections that has saved the healthcare industry millions of dollars. I have that identifies key drivers.More than 20 years of experience applying statistical analyses, predictive modeling, and SAS/R/Python programming across healthcare, financial, and mortgage industry data. Strong ETL experience ensuring data integrity and quality.Statistical and programming support for disease management, quality improvement activities for NCQA accreditation, survey research activities, and support of legal and medical policy divisions of the health care industryExperience in statistical detection of potential fraud, predictive modeling, and creation of mathematical and statistical models that measure riskOver 25 years of experience as a professional statistician, with statistical expertise in multiple linear regression, cluster analysis, PCA and multivariate techniques, time series and forecasting, logistic regression, decision trees, neural networks, support vector machines, data mining, descriptive statistics, and meaningful graphical techniquesPROFESSIONAL EXPERIENCEINDEPENDENT CONSULTANT/CONTRACTORSTATISTICAL AND DATA SCIENCE CONSULTINGFEBRUARY 2022  PRESENTMajor client was FL BCBS from 2/22 through 6/22, offering predictive modeling expertiseCORTEX ANALYTICS  REMOTEDIRECTOR OF ANALYTICSAPRIL 2021  FEBRUARY 2022Lead all analytical activities of a healthcare software and consulting company including risk adjustment, quality and utilization analyses and management, care and disease management, predictive modeling, and database coordination and ETLUtilized Natural Language Processing to train predictive models that included Electronic Health Records as predictive variablesTrain, mentor, and direct all activities of the healthcare programmers and data scientistsGDIT / ELIASSEN  REMOTESENIOR DATA ANALYSTNOVEMBER 2020  APRIL 2021Created predictive models and analyzed Part A. Part B, and DME utilization for Medicare Fraud, Waste, and Abuse developmentRe-programmed legacy SAS predictive modeling programs into PythonINFINITE COMPUTER SOLUTIONS  REMOTEHEALTHCARE STATISTICIANFEBRUARY 2020  NOVEMBER 2020Develop risk stratification and analytical models for a Care Management System using PythonDeveloped Natural Language Processing (NLP) techniques in Python to examine patterns in Electronic Health Records (EHR)IBM WATSON HEALTH, ANN ARBOR, MICHIGANMODELING LEADMAY 2017  NOVEMBER 2019Worked with an IT Team to develop a database used for Healthy China 2030, creating synthetic healthcare claims data and assuring clinical plausibilityAs a member of a core team of programmers I implemented statistical computing and SAS/WPS programming for the QEYAS Dubai Hospital Quality Measurement project to develop Provider Quality Measures for Dubai facilitiesLead a team of statisticians and programmers to develop the FPS2 Fraud, Waste, and Abuse platform for the Centers for Medicare and Medicaid Services (CMS)JACKSON-DAWSON, DEARBORN, MICHIGANDATA SCIENTISTFEBRUARY 2017  MAY 2017Created predictive models that identified key characteristics of automobiles to present to various market segments for advertisingCOMCAST SPOTLIGHT, BINGHAM FARMS, MICHIGANBUSINESS INTELLIGENCE ANALYSTOCTOBER 2015  SEPTEMBER 2016Used Time Series Models to forecast revenue for advertising lines of business within the Finance Department Identified business opportunities to implement financial corrections to increase revenue.NCI/ADVANCEMED, GROVE CITY, OHIOSENIOR STATISTICIANAPRIL 2015  JULY 2015Used multivariate statistical modeling and predictive analytics to fight Medicare Fraud, Waste, and AbuseQUICKEN LOANS, DETROIT, MICHIGANSTATISTICAL ANALYST/DATA MODELER, MARKET RESEARCH TEAMAUGUST 2012  FEBRUARY 2015Developed statistical models to prioritize business leads, supported market research efforts, and built statistical models to identify market segmentsWorked closely with internal marketing and mortgage banker clients to ensure the integrity of statistical models that were used for marketing attribution, using parametric and nonparametric approaches, including such methods as survival analysis and classification and regression trees (CART)UNITED HEALTH GROUP  OPTUMINSIGHT, MINNETONKA, MNPRINCIPAL STATISTICIANJULY 2011  MARCH 2012Developed reports and constructed statistical models using SAS that analyzed and modeled professional claims data for utilization review and fraud detectionHEALTH PLAN OF MICHIGAN, DETROIT, MICHIGANSENIOR MEDICAL MANAGEMENT ANALYSTMARCH 2011  JULY 2011Developed reports, graphs, and statistical analyses for a Michigan Medicaid HMOSAFEGUARD SERVICES, LLC (SGS), MIRAMAR, FLORIDASTATISTICIANJULY 2007  MARCH 2011Designed innovative statistical models to identify aberrant Medicare providers across all task orders, drew statistically valid random samples for the state of Florida, and performed ad hoc statistical analysesWELLPOINT, INC., INDIANAPOLIS, INDIANALEAD DATA MINING STATISTICIAN, STATISTICAL ANALYST IIIFEBRUARY 2002  JULY 2007As a Lead Statistician, led a team of data mining analysts to support the Benefit Integrity and Medical Review departments of a durable medical equipment (DME) Medicare contract by mining a large data warehouse to search for suspicious provider practice patterns. Worked with federal law enforcement to assist in identifying DME providers that were fraudulently billing Medicare and conducted audit samples for projected provider overpayments. Provided the Medical Review department with statistical analyses that helped drive medical policy.As a Statistical Analyst III, worked closely with Wellpoints Medical Directors to create statistical analyses that would identify providers who might benefit from provider education on proper usage of procedure codes. Gave presentations to the Centers for Medicare & Medicaid Services (CMS) outlining innovative statistical models and data analysis techniques. Developed state-of-the-art statistical models to measure utilization for the identification of audit candidates and to drive medical policy. Supported both contracts with statistical consultation as needed for ad hoc analyses.HEALTH CARE EXCEL, INDIANAPOLIS, INDIANASURVEILLANCE UTILIZATION REVIEW STATISTICIANDECEMBER 2000  FEBRUARY 2002Provided the Surveillance Utilization Review department with statistical support to identify, sample, and audit Indiana Medicaid providersDeveloped statistical models that assisted in the development of medical policiesProvided statistical consultation for ad hoc projects and served as a statistical expert for the state of Indiana in defense of audit sampling methodologiesBLUE CROSS OF NORTHEASTERN PENNSYLVANIA, WILKES-BARRE, PENNSYLVANIAMANAGER, STATISTICAL SERVICESDECEMBER 1995  JULY 2000Led a team of statisticians to support the Quality Management department using statistical design and implementation of all outcome studies and quality improvement activitiesProvided statistical support of all quality of care and customer service initiatives as prescribed by the National Committee for Quality AssuranceDeveloped utilization management profiling models to measure over- and under-utilization and to track provider performance across specialties and regional teamsBLUE CROSS AND BLUE SHIELD OF MICHIGAN, DETROIT, MICHIGANHEALTHCARE RESEARCH STATISTICIANJANUARY 1990  DECEMBER 1995Developed Provider Profiling systems to measure facility performance versus Peer GroupsDraw statistically valid random samples of paid claims by facility and compute overpayment projections for the Provider Audit departmentSupported the Medical Policy and the Legal departments with statistical analyses and estimationTECHNICAL EXPERIENCESAS, SPSS, R, Python, SQL, Power BI, Microsoft Office Suite (Excel, Word, PowerPoint, Access)EDUCATIONMA, Statistics, University of Michigan, Ann Arbor, MIBS, Statistics, University of Michigan, Ann Arbor, MI