Responsible for planning, direction, and operation of the Special Investigations Unit (SIU). Developing and directing the prevention, detection and investigation of anti-fraud, waste and abuse (FWA) program processes and oversight and coordination of all program integrity activities. The Director is responsible for ensuring all regulatory requirements are met including the completion of annual fraud plans and reports.Responsible lead as point of contact for collaboration with local, state and federal law enforcement and regulatory partners as well as senior executives throughout Geisinger.
COMPETENCIES AND SKILLS:
Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
Attracts, develops, and retains talent by creating an inclusive work environment that fosters employee engagement by building relationships of trust through active listening, empowering, caring, support and coaching.
Drives achievement of results by diagnosing business issues, setting high standards, developing plan(s) and process(as), creating an atmosphere of high performance, and holding others accountable
Motivates others to act by forging positive relationships internally and externally for the strategic benefit and outcome achievement of Geisinger’s mission and goals; personally demonstrates integrity, trust, accountability, collaboration, and empathy in all interactions
Builds strong and lasting relationships within own department and across departments through collaboration, mutual respect, shared decision making, credibility, reliability and communication while always keeping Geisinger’s mission in the forefront of working relationships.
Acts as a catalyst for change and innovation; Energizes others to embrace change and champions the transformation of the organization in new and effective directions.
Formulates objectives and priorities, and implements plans aligned to Geisinger’s mission and long-term interests.
Builds a shared vision with others and acts as a catalyst to transform and pursue organizational change.
EDUCATION AND EXPERIENCE:
5 Years of Health Insurance/Managed Care Experience
Bachelor’s Degree in Business Administration/Healthcare Management
Master’s Degree in Business Administration/Healthcare Management
Required Certifications or Licensures:
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. * Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.