Principal
Ryan is a partner-in-charge of the firm’s Benefit/Program Integrity (BPI) engagement team and a member of the Managed Care Compliance leadership team. Ryan is responsible for oversight of operations in the Austin, Texas and Nashville, Tennessee offices, as well as the management of health care and human service engagements across numerous state and federal agencies. Ryan co-leads the firm’s Innovation Council.
Over the course of his career he has overseen various engagements involving member, provider, and vendor fraud, waste and abuse detection, prevention, and recovery; managed care/health plan compliance; encounter claims analyses and auditing; benefit eligibility compliance; alternative payment methodology and value-based payment analyses and audits; federal nutrition program compliance; litigation support; and health and human service grant program compliance. His current responsibilities include providing high-level strategic input to state and federal agency clients, as well as general management and oversight of various engagements. His engagement responsibilities and experience include conducting on-site audits; evaluating provider, health plan, and vendor compliance with contractual and regulatory requirements; overseeing pre and post-payment review of service utilization claims; integrity monitoring for reimbursement systems; identification of aberrant billing and/or reimbursement practices; creation and analysis of complex data sets; analysis of expenditure and utilization trends; development of delivery system models; and preparation of written and oral reports and presentations.
Ryan is a Certified Fraud Examiner, and a member of the Association of Certified Fraud Examiners as well as the American Institute of Certified Public Accountants.
B.A., Finance, Ball State University
– Health and human service provider, member, vendor fraud, waste and abuse detection, prevention and recovery
– Health plan encounter and fee-for-service claims analysis
– Health and human service program oversight and consulting
– Program integrity
– Litigation support
– Leadership development
– High-level strategic support for state and federal clients
“Our work combines robust analytics, innovative thinking, and deep expertise to deliver impactful results for clients. Whether we’re uncovering fraud or improving program efficiencies, our commitment to integrity and excellence transforms the way health care and human service programs operate.”
— Ryan Farrell
