About the Role
Key Details: Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.
Develops, implements, and maintains third party risk management framework, policies, and procedures.
Evaluates third party compliance and performance by conducting pre-service, annual, and risk-based audits, and monitoring activities to measure performance against expectations, policies, procedures and requirements.
Manages issue resolution by identifying issues, recommending action plans, monitoring remediation activities and reporting on corrective action plan progress.
Leads risk assessments and due diligence processes for new and existing third parties.
Coordinates with cross-functional teams (such as Operations, IT Security, Procurement, Compliance, etc.) to identify, evaluate and manage third party risks.
Prepares and presents reports and dashboards for senior leadership and board of directors.
Supports internal and external audits related to third party compliance oversight by maintaining appropriate documentation, coordinating with third parties, performing quality review of submissions, and preparing presentations to stakeholders.
Monitors timely receipt of accurate and complete reporting for all regulatory and contractual-required reports required for the third party.
Serves as a key point of contact for third parties, providing guidance on contractual and regulatory obligations, and ensuring timely communication of new or updated requirements.
Manages and mentors a team of individual contributors that support third party risk management processes, fostering a culture of accountability and continuous improvement.
Allocates resources effectively to support third party risk management program activities.
Performs other duties as assigned.
Complies with all policies and standards.
Requirements
Education/Experience
- Bachelor's Degree Business Management, Health Administration, or related equivalent work experience required
- 5+ years Audit, Compliance, third party oversight and/or related experience required
- Knowledge of Medicare, Medicaid, Marketplace and health plan administration preferred
- Project management experience in planning, coordinating and executing projects preferred
About the Company
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.