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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.
Job Responsibility:
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
Requirements:
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
Nice to have:
Master’s degree in Healthcare Administration, Nursing, or Business
What we offer:
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