Lauren Toth
Senior Director of Technology Program Management – Defense Enterprise & Health Solutions BU, DMHS Sector, Peraton
Lauren Toth holds a Ph.D. in biomedical engineering, and is working with her teams to support the Centers for Medicare and Medicaid Services Fraud Prevention System, which helps CMS combat medical fraud, waste and abuse. This is a major personal and professional achievement for her.
The team helped save CMS a significant amount of money by accurately flagging fraudulent claims. Building upon this expertise, Toth led Peraton engineers in developing Rapid Fraud Intelligence, which is a commercial product designed to help any agency find and combat fraud.
Toth combines her background in biomedical and chemical engineering with her experience leading innovation-driven technical teams to deliver solutions that meet customers’ most critical mission needs, said Omer Khan, vice president of benefits, claims and integrity solutions, DMHS, at Peraton.
“As program director of the Fraud Prevention System program, her teams have received many industry awards for leveraging advanced technologies to deliver ever increasing ROI for CMS and safeguarding taxpayer dollars,” he said. “Lauren has also leveraged this expertise to evolve our ability to detect and prevent fraud, waste, and abuse with Peraton’s Rapid FI platform. We are proud of her leadership that has bridged our customers to their strategic vision through deep understanding of the mission.”
Why Watch
Health security is national security. Throughout this year and beyond, Toth and her team are committed to implementing new tools to support CMS’ fraud investigators and help them combat more fraud. Every improper payment that is prevented has a direct correlation to increased savings for American taxpayers and ensures the nation’s healthcare budget supports those who need it the most — Medicare and Medicaid beneficiaries.
Peraton also helps the current administration identify and mitigate fraud; reduce the costs associated with fraud, waste and abuse; and ensure the right benefits go to the right people. Using the latest technology, the team provides fraud detection models, risk scores, visualizations and reports that help investigators prioritize their workload and investigations, increasing efficiency and return on investment.
“I am extremely proud of the work my team has accomplished. I’m lucky to work with the best and brightest engineers and investigative experts in the industry,” Toth said. “Together, we deploy cutting-edge technology to help customers stay ahead of emerging fraud schemes and protect our nation’s healthcare budget. We’re trailblazers, and each day I’m fueled by my team’s energy and innovative spirit.”
Fun Fact: From a broken nose to building a business focused on female athletes, Toth has a colorful track record in problem solving. She holds two U.S. patents for protective softball equipment still sold worldwide today.