Director, Special Investigations Unit Geisinger Health Plan
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.
5 Years of Health Insurance/Managed Care Experience
Bachelor's Degree in Business Administration/Healthcare Management