Learn Data Skills
Beta
Jared Williams

Jared Williams

Data Science Fraud Manager

Blue Cross Blue Shield of Massachusetts

Technologies

My Portfolio Highlights

My New Course

Introduction to Python

My New Project

Analyze International Debt Statistics

My New Workspace

Project

Data visionary, envisioning a future transformed by the power of information.

My Work

Take a look at my latest work.

workspace

Project

workspace

Project: Analyzing Students' Mental Health in SQL

workspace

Project: Analyzing Motorcycle Part Sales

DataCamp Course Completion

Take a look at all the courses I’ve completed on DataCamp.

My Work Experience

Where I've interned and worked during my career.

Blue Cross Blue Shield of Massachusetts | May 2023 - Present

Data Science Fraud Manager

N/A

CVS Caremark | Mar 2023 - May 2023

Senior Decision Scientist - Fraud, Waste and Abuse

N/A

Aetna, a CVS Health Company | May 2019 - Mar 2023

Sr. Analyst

- Research and ad hoc report development to identify fraud, waste and abuse schemes and trends. - Staying up do date with new and emerging fraud, waste and abuse schemes and trends through training sessions and industry resources. - Review the clinical & payment policies to determine the impact of the schemes on the business. - Create and document requirements and work with data science business partners to create business rules that use claim data to auto generate Fraud, Waste or Abuse leads for investigation. - Stay up to date with coding changes to ensure that existing business rules are being updated as well. - Analyze and present key findings to internal customers to provide recommendations based on the findings. - Create VBA macros for each business rule to create efficiency and consistency within referral process. - Utilize SAS enterprise guide create process flows which automate and generate weekly reports to be reviewed for newly flagged providers. - Utilize Power BI to present metrics through visualizations on a quarterly basis. - Conduct Excel and Power BI trainings for the Special Investigations Unit.
Show More

Commonwealth of Massachusetts | Sep 2017 - May 2019

Data Analytic Fraud Examiner

N/A

Commonwealth of Massachusetts | Mar 2017 - Sep 2017

Fraud Examiner

- Analyzed irregularities with subjects that have allegations against them for committing public assistance fraud. - Obtained evidence that will support allegation such as if subject was on assistance at the time. - Escalated case to senior examiners if it meets the criteria of public assistance fraud. - Met regularly with Assistant Director regarding investigations. - Trained new staff on projects - Prepared reports, evidence, and correspondence concerning investigations of public assistance fraud to provide required information and makes appropriate recommendations concerning investigations. - Utilized different data warehouses for investigations.

Santander Consumer USA Inc. | Mar 2016 - Mar 2017

Fraud Specialist II

- Analyzed case details to identify methodology of each fraud scheme, assess existing preventive controls, identify control gaps, recommend and implement mitigation strategies. - Contributed to Key Performance Indicators, prevention results, and fraud loss management reports. - Maintained the case management system for tracking fraud cases and relevant information. - Monitored the performance of the rules to ensure that agreed risk levels and positive customer experience are maintained. - Examined account transactions such as check deposits to verify their validity. - Documented results of actions taken to support fraud trending and reporting. - Analyzed loss experienced based on monthly/quarterly/annual losses for trending. - Provided support to Field Investigators, senior analysts, and Loss Prevention Team Managers. - Complied with all applicable federal regulations in decision process. - Utilized Microsoft Excel and Access for Data Analysis for discovering outliers - Demonstrated proficiency of applicable systems, tools, policies and procedures, and bank regulations. - Assisted in new ways to mitigate losses.

Santander Consumer USA Inc. | Jul 2014 - Mar 2016

Fraud Specialist

- Researched and analyzed high risk transactions across all payment channels with a sense of urgency in a fast paced environment. - Identified fraud patterns and communicated observations to analysts and management. - Collaborated with internal and external customers to make decisions on transactions and perform appropriate actions required to mitigate losses. - Facilitated special projects as the lead role.

My Education

Take a look at my formal education

Master of Science - MS, Applied Data Analytics in Applied Data AnalyticsBoston University - Metropolitan College | 2023
20461 Querying Microsoft SQL Server  New Horizons Computer Learning Centers - Englewood | 2018
Bachelor of Science - BS, Criminal JusticeBridgewater State University | 2013

About Me

Jared Williams

I am a data enthusiast and always looking to learn new techniques and concepts

Powered by

  • Work
  • Courses
  • Experience
  • Education
  • About Me
  • Create Your Data Portfolio for Free