Susan Frisco
Associate Director at Guidehouse - Healthcare Fraud SME - Investigations and Compliance
- Role
- Associate Director at Guidehouse
- Location
- Somerville, NJ, US
- LinkedIn followers
- 500 followers
About Susan Frisco
After over 28 years in the public service, I successfully made the transition to the…
Experience
Associate Director
Jan 2024 — Present · New York, NY, US
Directed Fraud, Waste, and Abuse (FWA) initiatives for the Department of Veterans Affairs (VA), developed and implemented data analytics program to detect FWA; created FWA Training for VA employees; updated nine Standard Operating Procedures; designed standardized forms to increase operational efficiency; value-tracked client efforts; prepared 3-year forecast plan; provided investigative support and subject matter expertise. Served as Project Manager for Department of Justice contract, analyzed cost/benefit efficiency of DOJ investigative efforts, including preparation of the Return on Investment for the Health Care Fraud and Abuse Controls (HCFAC) Report for fiscal year 2024; prepared written analyses and final report estimating the impact of HCFAC enforcement activity on fraud prevention and deterrence.Managed a team supporting the defense of a health care fraud investigation, completed necessary document analysis, including review of over 75 separate contracts; oversaw the forensic accounting analyses relating to governmental allegations of tax fraud and payment of kickbacks; prepared necessary investigative factual analyses, including observation summaries; prepared outside counsel, including at weekly status meetings; advised, educated, and prepared client regarding findings, meaning, and defense recommendations. Developed scalable multi-use fraud detection tool, provided subject matter expertise to establish fraud typology and proof of concept; worked closely with data analytics team to prove, sensitize, and deploy; reviewed, finalized, and presented to executive leadership for client utilization.Led FWA and Investigations section of Big Pharma panel discussion, presenting to the Global Investigations Team, attorneys and investigators from the Legal and Compliance Divisions, the Corporate Audit Team, and the Global Security Team; discussed investigative skills and techniques; reviewed large corporate compliance challenges in Big Pharma.
Education
Rutgers University–New Brunswick
Bachelor of Science - BS, Criminal Justice
University of Delaware
Bachelor of Arts - BA, Criminal Justice/Police Science
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