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US Tech Solutions · 8 hours ago

Vice President, Government and Commercial Programs

US-Nationwide

Full-time

Hybrid

Director/Executive

$130K/yr - $160K/yr

12+ years exp

Allied Universal® Compliance and Investigation Services is a global leader in insurance claim investigation. They are seeking a Vice President, Government and Commercial Programs who will be responsible for managing government and commercial healthcare operations, driving commercial growth, and overseeing P&L responsibilities across both sectors.

Information Technology

Growth Opportunities

No H1B

Security Clearance Required

Responsibilities

Oversee the strategic direction and function of Government and Commercial Programs within the Advize operations line of business including P&L oversight to achieve organizational goals

Responsible for the day-to-day oversight of the operational efficiency and effectiveness of the clinical auditing, compliance and special investigations unit organization, to include special programs such as Physician, Managed Care, Pharmacy, PACE, and Special Needs

Create and implement Process Improvement strategies resulting in best-in-class concept management processes to improve fraud, waste and abuse

Act as subject matter expert related to government acquisition processes, rules, and regulations

Serve as needed as experienced witness for litigation and federal cases, providing expert testimony in complex fraud, waste and abuse legal proceedings

Qualification

P&L oversightHealthcare leadershipFraud wasteAbuseGovernment contractingHealthcare regulation knowledgeAnalytical skillsMicrosoft OfficeCommunication skillsOrganizational skills

Required

Must possess one of the following: Bachelor's degree in Healthcare Administration, Nursing, or Business or Associate's degree in Healthcare Administration, Nursing, or Business with a minimum of fifteen (15) years of experience in healthcare leadership roles

Must possess, or be able to obtain, a government security clearance

Minimum of twelve (12) years of experience in P&L and/or business oversight, inclusive of a combination of healthcare and cost management analytics, specializing in payment integrity, fraud waste and abuse programs

Minimum of twelve (12) years of experience in progressive healthcare leadership roles

Demonstrated ability to win new business within government contracting and commercial sectors

Ability to effectively partner with law enforcement and regulatory agencies to report fraud and abuse, ensuring adherence to industry standards and regulations

Knowledge of healthcare regulation and compliance policies as well as medical terminology

Excellent analytical and critical thinking skills

Proficiency in Microsoft Office

Ability to remain highly productive in a changing environment, strong attention to detail, organizational skills, and maintain a high level of discretion with sensitive information

Effectively oral and written communication skills

Preferred

Master's degree in Healthcare Administration, Nursing, or Business

Benefits

Medical, dental, vision, basic life, AD&D, retirement plan and disability insurance

Seven paid holidays annually, sick days available where required by law

Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law