Director - Compliance

Sagility•Time, IL

2d•Remote

About The Position

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries. The Director, Compliance Investigations (SIU) & Internal Audit leads the organization’s investigations, audit, and assurance functions across a global healthcare and the geo specific environment. This is considered Head of SIU and ensures whistleblower and misconduct investigations, regulatory and client-driven audits, and enterprise control assurance, ensuring compliance with CMS, OIG, HIPAA/HITECH, client contracts, and local country regulations. The role provides independent, credible assurance to executive leadership and the Board, connects incident trends to risk and control improvements, and drives a mature, defensible, and audit-ready compliance program.

Requirements

Bachelor’s degree in Business, Accounting, Compliance, Law, Criminal Justice, or related field or applicable experience may be accepted.
4 years of experience in Compliance, HR, Investigations, Internal Audit, Risk, or Regulatory Assurance experience may be substituted.
Strong experience in healthcare, BPO, or other highly regulated environments.
Demonstrated experience managing sensitive investigations and audit and assurance programs.
Excellent analytical, writing, and executive communication skills.
High integrity, independence, and strong professional judgment.

Nice To Haves

Experience with CMS, OIG, HIPAA, SOC, ISO, NIST, SOX, and multi-country regulatory frameworks but not required
Experience with GRC and case management tools (AuditBoard, Ethico, Archer, ServiceNow). But not required.
Experience supporting Board-level reporting and Audit Committee interactions.

Responsibilities

Lead investigations related to whistleblower and ethics hotline reports, fraud, waste and abuse (FWA), data privacy and information security incidents, employee misconduct, retaliation, harassment, conflicts of interest, and client or regulatory compliance breaches.
Directs and manages the end-to-end case lifecycle: intake, triage, scoping, evidence collection, interviews, findings, and closure.
Ensure investigations meet CMS, OIG, HIPAA/HITECH, DOJ guidance, client contractual requirements, and local country laws (e.g., India DPDP, Philippines DPA, Jamaica DPA, Colombia regulations).
Maintain strict confidentiality, non-retaliation protections, and defensible documentation standards.
Partner with Legal, HR, Information Security, Compliance, Operations, and leadership on sensitive matters.
Plan and execute compliance audits, operational and process audits, and regulatory and client audit readiness reviews.
Evaluate internal control design and operating effectiveness, compliance with laws, regulations, and contracts, and risk management practices across functions and geographies.
Develop audit scopes, work programs, testing plans, and reports.
Document findings, risk ratings, root causes, and corrective action plans.
Track remediation and escalate overdue or ineffective actions.
Use investigation trends and audit results to identify systemic risks and control gaps and drive preventive and corrective actions.
Contribute to and challenge the enterprise risk register.
Reduce repeat incidents and recurring audit findings.
Strengthen policies, procedures, and controls and promote a culture of compliance and accountability.
Assist in reporting for Executive Leadership, Audit Committee / Board, regulators, and clients as required.
Assist in the production integrated reporting on investigation volumes and trends, audit results and risk themes, remediation status, and control maturity.
Ensure accurate, timely, and defensible reporting.
Support regulatory exams, client audits, and external assurance activities.
Own or help administer GRC and case management platforms (e.g., AuditBoard, ComplianceLine/Ethico, Certiphi and EY compliance Management Tool).
Standardize investigation methodologies, audit methodologies, and issue and remediation tracking workflows.
Improve program maturity, metrics, and automation and reduce reliance on manual or off-system tracking.