John Kimble MBA, AHFI

Experience

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  Waller County Sheriff's Office

  Mar 1992 - May 1999

  Deputy/ Warrant Extradition Officer/ Corrections Officer

  Responsibilities as a peace officer with the Waller County Sheriff's Office included developing criminal cases for presentation to the local district attorneys and the municipal court system. Trained new patrol staff, and maintained a standard of security in district, county and justice of the peace court rooms. Responsible for the transportation of inmates throughout the United States and served as a shift supervisor while working in the corrections division. During that time, was responsible for the care, control and custody of up to 150 inmates on any given day. Professional Accomplishment - While Employed at the Waller County Sheriff's Office awarded the 1998 Waller County Peace Officer of the year award, presented for outstanding service to the citizens of Waller County. Show less

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  Katy ISD Police

  May 1999 - Oct 2005

  Peace Officer

  Responsible for investigating cases involving criminal and non-criminal components and presented the findings of those investigations to various entities. Trained new patrol staff and provided guidance on completing investigations as well as how to conduct themselves on a day to day basis. Researched and submitted federal and local grants totaling $700,000 to the US Department of Justice COPS program. Responsible for the safety of large crowds at various events throughout the school district, and volunteered with the Explorer program, which is a program that participates in police practice competitions throughout the State of Texas. Show less

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  Waller Police Department

  Jan 2006 - Mar 2007

  Investigator

  Developed criminal cases for presentation to the local and district attorneys, trained and coached new employees and acted in the role of a firearms instructor. Conducted complex criminal investigations and assisted in developing the curriculum for the Citizens on Patrol Academy as well as conducting internal affairs investigations in a timely and sensitive manner.

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  Texas Department of Family and Protective Services

  Mar 2007 - Nov 2009

  Senior Investigator & Consultant

  In this role, I led critical investigations that improved operational practices within Children's Protective Services. My collaborative efforts with medical examiners on death cases were integral to the strategic enhancements in case management and investigative outcomes.

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  Texas Health and Human Services Commission

  Nov 2009 - Jun 2012

  Sergeant Investigator – Internal Affairs

  I led high-level internal affairs investigations, ensuring compliance with state and federal regulations. My work involved providing strategic recommendations to improve security and operational standards at various supported living centers, enhancing overall facility safety and compliance.

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  Waller County Constable PCT 4

  Jun 2012 - now

  Deputy Constable

  *Volunteer Position* The Waller County Constables Office enforces local and state laws as well as protecting persons and properties by investigating complex criminal cases including, forgery, thefts, burglary, financial crimes and assaults against persons as well as all other criminal offenses outlined in the Texas Penal Code. As part of this agency, the duties are also to act as a public relations representative of the office.

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  Universal American

  Jun 2012 - Dec 2014

  Senior Investigator

  At Universal American, I played a key role in managing a diverse caseload aimed at detecting and preventing fraud. My leadership in training team members and refining investigative processes significantly enhanced our team's precision and effectiveness in handling fraud, waste, and abuse cases.

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  Humana

  Nov 2014 - Mar 2021

  Team Lead & Fraud Investigator - Humana Inc.

  As the founding member of the Government Referral Panel at Humana, I led numerous high-profile identity theft investigations, including a notable case that resulted in a $170k recovery. My role was crucial in setting up operational standards for policy compliance and fostering a culture of ethical integrity. Through meticulous data analysis, my team and I successfully identified fraudulent enrollments, preventing approximately $2M annually in potential losses.

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  KelseyCare Advantage

  Mar 2021 - Jun 2024

  Senior Fraud Investigator, Compliance Auditor & FWA SME

  In my current role at Kelsey Care Advantage, I established and now lead the Special Investigations Unit (SIU), developing policies that integrate seamlessly with broader corporate compliance frameworks. I oversee large-scale data analysis initiatives that significantly enhance fraud detection, impacting billing integrity and compliance. My strategic leadership in establishing case tracking systems and conducting HR investigations reinforces our organization's commitment to rigorous regulatory compliance and ethical practice. Show less

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  CareSource

  Jun 2024 - now

  Investigator III

  At Caresource, I play a key role in managing a diverse caseload aimed at detecting and preventing fraud. Using an analytical approach to reviewing data to determine billing anomalies. Providing experienced insight into investigative practices and outcomes.