Senior Director, Third Party Risk Management

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $134.6k - $249k / year

⏰ Full Time

🟠 Senior

🔒 Insurance

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Provides enterprise-wide leadership and strategic direction for third party risk management from a compliance perspective • Establishes the governance model, risk framework, enterprise standards, and multi-year roadmap for third party compliance risk • Leads audit, monitoring, compliance, and delegated oversight programs for third parties and delegated healthcare functions • Defines operating roadmaps, investment priorities, performance measures, scalable processes and technology, and organizational capabilities • Owns the enterprise third party risk management framework, including risk segmentation, due diligence standards, control expectations, quality assurance, and program effectiveness evaluation • Leads risk-based audit plans and oversees audit planning, execution, reporting, and validation • Oversees auditing and monitoring of delegated operational, regulatory, clinical, pharmacy, claims, credentialing, utilization management, customer service, and other healthcare functions • Directs third party lifecycle oversight, including due diligence, risk assessment, compliance monitoring, performance oversight, issue management, corrective action, termination or transition risk, and regulatory readiness • Directs issue identification, root cause analysis, corrective action validation, closure, escalation, remediation, and reporting • Chairs enterprise governance forums and directs cross-functional decisions across Compliance, Legal, Procurement, Operations, Enterprise Risk, and business stakeholders • Leads responses to CMS audits, external quality reviews, regulatory examinations, delegated oversight reviews, external audits, and compliance assessments • Advises executive leaders and business owners on regulatory change, emerging risk, third party concentration or dependency concerns, and significant control gaps • Directs executive and board-level reporting on risk exposure, trends, material issues, program performance, and remediation status • Leads directors, people leaders, auditors, monitoring specialists, compliance analysts, and delegated oversight professionals • Establishes organizational structure, resource planning, succession and talent strategies, leadership expectations, and accountability • Performs other duties as assigned • Complies with all policies and standards

🎯 Requirements

• Bachelor's Degree Business Management, Health Administration, or related field; or, equivalent work experience • 10+ years progressively responsible experience in audit, compliance, enterprise risk, and/or third party risk management, including responsibility for complex, enterprise-scale programs • Leadership experience leading managers or other people leaders and directing work across multiple business areas or operating units • Experience advising executive leadership and presenting material risk, program performance, or regulatory matters to executive governance committees and/or boards • Knowledge of healthcare regulatory requirements and government-sponsored programs, including Medicare, Medicaid, and Marketplace environments • Certified Internal Auditor (CIA) certification required • Certified in Healthcare Compliance (CHC) preferred

🏖️ Benefits

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules

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