副总裁，政府与商业项目
Vice President, Government and Commercial Programs
Overview
Company Overview:
在 Allied Universal® 合规与调查服务部门，开启你的保险理赔职业发展之路。Allied Universal® 合规与调查服务是保险理赔调查职业的首选之地。作为全球领导者，我们为理赔调查员、SIU 调查员和监控调查员提供充满活力的机会。我们的团队致力于创新和卓越，对保险行业产生重大影响。如果你准备与最好的团队一起成长，探索我们的职业机会，创造不同。
Job Description
这是一个混合办公远程职位。
Allied Universal® 正在招聘副总裁，政府与商业项目。副总裁，政府与商业项目负责所有政府和商业医疗保健运营，同时管理与政府机构的互动，并同步制定和执行策略，推动商业增长并负责公共和私营部门的利润与损失（P&L）。副总裁，政府与商业项目将需要在美国境内进行一些过夜旅行。
RESPONSIBILITIES:
- 在 Advize 业务线中，负责政府与商业项目的战略方向和职能，包括 P&L 监督以实现组织目标
- 负责临床审计、合规和特别调查单位的日常运营效率和效果监督，包括特殊项目如医生、管理护理、药房、PACE 和特殊需求项目
- 制定并实施流程改进策略，实现一流的概念管理流程，以改善欺诈、浪费和滥用问题
- 作为政府采购流程、规则和法规方面的专家
- 在需要时作为经验丰富的证人参与诉讼和联邦案件，为复杂的欺诈、浪费和滥用法律程序提供专家证词
QUALIFICATIONS (MUST HAVE):
- 必须具备以下之一：
- 医疗保健管理、护理或商业专业的学士学位
- 医疗保健管理、护理或商业专业的副学士学位，并具有至少十五（15）年医疗保健领导岗位的经验
- 必须拥有或能够获得政府安全许可
- 至少十二（12）年的 P&L 和/或业务监督经验
查看英文原文
Overview
Company Overview:
Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you’re ready to grow with the best, explore a career with us and make a difference.
Job Description
This is a hybrid work remote role.
Allied Universal® is hiring a Vice President, Government and Commercial Programs. The Vice President, Government and Commercial Programs is responsible for all government and commercial healthcare operations in addition to managing interactions with government entities while concurrently developing and executing strategies to drive commercial growth and Profit & Loss (P&L) responsibility across both public and private sectors. The Vice President, Government and Commercial Programs will expect some overnight travel within the United States.
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
QUALIFICATIONS (MUST HAVE):
- Must possess one of the following:
- Bachelor’s degree in Healthcare Administration, Nursing, or Business
- 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 QUALIFICATIONS (NICE TO HAVE):
· Master’s degree in Healthcare Administration, Nursing, or Business
BENEFITS:
- Annual Salary Range - $130,000 - $160,000 depending on geographic location
- 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
Closing
Allied Universal® is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.
Requisition ID
2025-1506408Originally posted on Himalayas