Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
SoftwareDeveloper
William S. Miller

William S. Miller

Investigations/Compliance/Program Integrity
Port Orchard,WA

Summary

A highly accomplished leader who possesses expertise in developing successful organizational initiatives. Proven ability to formulate work teams that include both internal and external partners to increase effectiveness and efficiency at all levels of an organization. A proven ability of using a variety of project management techniques to evaluate complex project, contract, and industry operations in support of senior executive decisions that result in positive changes which enhance personnel morale and overall organizational productivity and efficiency.

Overview

33
33
years of professional experience

Work History

Program Integrity Manager (Investigations Manager)

Elevance Health
01.2017 - Current
  • Manage and coach a team of investigators and administrative staff for the Elevance Health Texas Medicaid Contract
  • Manage all Medical Provider and Pharmaceutical investigations related to Texas Medicaid
  • Oversee all Special Investigations Unit (SIU) Program Integrity activities for the Texas Medicaid Team
  • Prepared comprehensive executive summaries of investigations and results
  • Negotiate recoveries of overpayments made to medical providers
  • Worked with law enforcement partners on cases with joint interest
  • Drafted organizational policy changes resulting in a more effective and efficient provider fraud program
  • Lead awareness briefings to key operators and stakeholders
  • Lead internal compliance reviews
  • Keeps and maintains a healthy load of complex investigation

Assistant Special Agent in Charge (ASAC)

United States Postal Service Office of Inspector General
01.2002 - 01.2017
  • Led and coached a team of Special Agents and Administrators for a team responsible for investigating all employee misconduct in a multi-state area
  • Cases included, employee theft and embezzlement, workers compensation fraud, financial fraud, and employee violence investigations
  • Led the formation of a newly created national procurement and healthcare provider fraud division within the organization
  • Investigations included major pharmaceutical fraud cases
  • Proven organizational and investigative program development led to the establishment of three new offices in the Western U.S
  • Successful team leadership and project management led to the receipt of an award from the Council of the Inspector General for Integrity and Efficiency for recovering over $70 million from a Government contractor
  • Established Continuity of Operations Plans
  • Recruited, interviewed, hired, and mentored personnel
  • Led a team of forensic accountants that supported complex fraud investigations increasing investigative efficiency by over 40%
  • Drafted and recommended organizational policy changes resulting in a more effective and efficient contract fraud program
  • Conduct internal and external compliance reviews
  • As the division Public Affairs Officer, drafted and published numerous press releases

Senior Special Agent

United States Postal Service Office of Inspector General
01.2002 - 01.2004
  • Responsible for the investigation and successful prosecution of multiple million-dollar complex contract, pharmaceutical and health care fraud investigations involving cost mischarging, upcoding, false claims, false statements, unapproved parts, bribery, off-label marketing, and kickbacks
  • Recognized for having the top investigation in the OIG in 2003
  • Was the first Agent to establish a USPS OIG office in Seattle, WA
  • Established a USPS OIG criminal and civil investigative presence in Washington State, Idaho, Montana, and Alaska
  • Established professional relationships with government executives and external stakeholders in the furtherance of the USPS OIG mission
  • Used knowledge of law enforcement databases in the furtherance of the USPS OIG mission and to exceed established organizational goals resulting in increased prosecution rates and increased monetary benefits to the organization
  • Provided expert guidance to junior Special Agents in criminal and civil law in the furtherance of overall organizational goals

Resident Agent in Charge/Special Agent

National Aeronautics and Space Administration Office of Inspector General (NASA OIG)
01.1992 - 01.2002
  • Supervised a team of 10 Special Agents from 1999 through 2002
  • Conducted and supervised complex procurement fraud and employee Investigations
  • Recognized by the Presidential Council on Integrity and Efficiency for a successful multi-million dollar contract fraud investigation
  • Developed sophisticated data mining techniques to identify fraud schemes
  • Joint Federal Procurement Task Force leader staffed by multiple federal investigative agencies
  • Testified in both federal and state criminal trials
  • Opened new investigative office at the Dryden Flight Research Center

Education

Doctor of Business Administration - Criminal Justice and Security

Northcentral University
Prescott, AZ

Master of Science - Leadership with an Emphasis in Crises Management and Disaster Preparedness

Grand Canyon University
Phoenix, AZ

Bachelor of Science - Business Administration and Accounting

Southern Utah University
Cedar City, UT

Skills

  • Organizational Oversight
  • Pharmaceutical Fraud Investigations
  • Contract Fraud Investigations
  • Internal Employee Investigations
  • Investigative Program Development
  • Leadership
  • HR Investigations
  • Compliance
  • Project Management
  • Healthcare Fraud
  • Credit/Gift Card Theft and Fraud

Affiliations

  • Association of Certified Fraud Examiners, 01/01/16, 12/31/18
  • Northwest Council of Inspector Generals, 01/01/02, 12/31/17
  • Federal Law Enforcement Officers Association, 01/01/02, 12/31/17
  • The National Health Care Anti-Fraud Association, 01/01/17, 12/31/24

Timeline

Program Integrity Manager (Investigations Manager)

Elevance Health
01.2017 - Current

Assistant Special Agent in Charge (ASAC)

United States Postal Service Office of Inspector General
01.2002 - 01.2017

Senior Special Agent

United States Postal Service Office of Inspector General
01.2002 - 01.2004

Resident Agent in Charge/Special Agent

National Aeronautics and Space Administration Office of Inspector General (NASA OIG)
01.1992 - 01.2002

Master of Science - Leadership with an Emphasis in Crises Management and Disaster Preparedness

Grand Canyon University

Bachelor of Science - Business Administration and Accounting

Southern Utah University

Doctor of Business Administration - Criminal Justice and Security

Northcentral University

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