Director, Risk & Compliance Processes – Initiatives

Responsibilities

• Develops and implements strategies to ensure successful maintenance and implementation of compliance and risk programs that meet regulatory requirements for assigned products across the enterprise
• Champions cross-functional collaboration by working closely with Risk & Compliance teams, business units, legal, IT, and operational leaders
• Leads the documentation of processes and controls
• Oversees the review and periodic update of compliance process documentation
• Coordinates with the GRC Administration team, Compliance Systems & Reporting
• Serves as the principal liaison between business/process stakeholders and technology teams
• Architects and implements governance structures for the GRC application
• Designs and maintains robust standards and criteria for business cases submitted to the governance committee
• Leads efforts to ensure the accuracy and currency of field values within the GRC application
• Develops a framework to evaluate and interpret data outputs and reporting

• Bachelor's Degree in Business Administration or related field; or equivalent experience required
• 7+ years related program management experience required
• Governance, risk, and compliance applications experience required
• Compliance program management experience preferred
• Managed care contract experience with state Medicaid, Medicare, or commercial programs, including internal and state audits preferred
• Working with healthcare regulatory agencies in the development of compliance and fraud programs preferred
• Oversight of implementation of federal or state insurance or program requirement preferred