Senior Director, Third Party Risk Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Provides enterprise-wide leadership and strategic guidance for third-party risk management from a compliance standpoint.

• Develops the governance model, risk framework, enterprise standards, and multi-year roadmap for compliance risks associated with third parties.

• Oversees audit, monitoring, compliance, and delegated oversight programs related to third parties and delegated healthcare functions.

• Defines operational roadmaps, investment priorities, performance metrics, scalable processes and technologies, and organizational capabilities.

• Owns the comprehensive third-party risk management framework, which includes risk segmentation, due diligence standards, control expectations, quality assurance, and evaluation of program effectiveness.

• Leads risk-based audit strategies and supervises the planning, execution, reporting, and validation of audits.

• Manages the auditing and monitoring processes for delegated operational, regulatory, clinical, pharmacy, claims, credentialing, utilization management, customer service, and other healthcare functions.

• Directs the oversight of the third-party lifecycle, including due diligence, risk assessment, compliance monitoring, performance oversight, issue management, corrective actions, termination or transition risks, and regulatory preparedness.

• Directs the identification of issues, root cause analyses, validation of corrective actions, closure, escalation, remediation, and reporting.

• Chairs enterprise governance forums and guides cross-functional decisions involving 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 changes, emerging risks, concerns regarding third-party concentration or dependency, and significant control deficiencies.

• 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 the organizational structure, resource planning, succession and talent strategies, leadership expectations, and accountability.

• Performs additional duties as assigned.

• Adheres to all policies and standards.

⛳️ Requirements

• Bachelor’s Degree in Business Management, Health Administration, or a related field; or equivalent work experience.

• Over 10 years of progressively responsible experience in audit, compliance, enterprise risk, and/or third-party risk management, including oversight of complex, enterprise-scale programs.

• Leadership experience in managing teams or directing work across multiple business areas or operating units.

• Proven experience advising executive leadership and presenting material risk, program performance, or regulatory issues to executive governance committees and/or boards.

• In-depth knowledge of healthcare regulatory requirements and government-sponsored programs, including Medicare, Medicaid, and Marketplace environments.

• Certified Internal Auditor (CIA) certification is mandatory.

• Certification in Healthcare Compliance (CHC) is preferred.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements, including remote, hybrid, field, or office work schedules.