NAME: Nina Burnett
NEW JOB TITLE: Lansing, Michigan-based director, investigative services, AF Group
PREVIOUS POSITION: Lansing, Michigan-based director, investigative services, AF Group
INDUSTRY OUTLOOK:
GOALS FOR NEW POSITION: My goal is to preserve and enhance AF Groups standing as a best-in-class investigations unit. I look forward to expanding the impact of AF Groups fraud and causation investigations through increased data analytics. Causation analysis and early, proactive detection of suspect claims are two powerful tools to protect our insureds and the integrity of workers compensation programs.
CHALLENGES FACING THE INDUSTRY: A major challenge relates to assessing the COVID-19 impacts on fraud. The economic and labor upheaval of the past year present new opportunities for criminals to exploit. Disruption in the labor market and in the way health care is provided has opened the door for new schemes. For example, the growth and adoption of telehealth has been a wonderful way for individuals to safely connect with providers and get care during the pandemic. Unfortunately, there are also individuals who are engaged in telemarketing fraud, but camouflage their activity as telehealth, resulting in payments for medically unnecessary and unwanted services and supplies. We need to stay a step ahead and expect twists in the way medical fraud, premium fraud and exploitation of injured workers is attempted in the changing workplace.
FIRST EXPERIENCE IN THE INDUSTRY JOB MARKET: I began working health care fraud investigations as an FBI Agent. I had worked a variety of white-collar criminal investigations, but then started specializing in health care fraud in the mid-1990s when the recognition grew that billions of health care dollars were being lost to fraud and abuse.
ADVICE: Think broadly. Learn as much as you can about all the different business areas within your company. Understanding the larger picture and the goals and priorities of other areas will create opportunities to expand the impact of your own work. Never be shy about reaching out to peers or leaders in another business group and ask them to describe their role. People like to talk about what they do.
OUTSIDE THE INDUSTRY, A DREAM JOB: Theater critic
COLLEGE MAJOR: Ancient history
LOOKING FORWARD TO: AF Group is such a dynamic and evolving company; Im excited to see how well continue to grow and create new opportunities that will allow my team to increasingly mitigate risk and minimize the impact of potential fraud, waste and abuse.
FAVOURITE MEAL: A well-seasoned filet followed by chocolate cake.
BOOK: Into Thin Air by Jon Krakauer individuals pushed to their physical limits and interesting ethical questions that evolve.
HOBBIES: Running, biking, baking, being outdoors and active.
TV SHOW: Survivor
ON A SATURDAY AFTERNOON: Get out for a long bike ride.
