Senior Director, Third Party Risk Management

Centene Corporation • Remote-MO, MO

2d • $134,600 - $249,000 • Remote

About The Position

Provides enterprise-wide leadership and strategic direction for third party risk management from a compliance perspective, including audit, monitoring, and oversight of delegated healthcare functions. Establishes the governance model, risk framework, enterprise standards, and multi-year roadmap to identify, assess, monitor, escalate, and remediate third party compliance risk across Medicare, Medicaid, and Marketplace environments. Is accountable for program effectiveness, risk-based audit and monitoring, regulatory and accreditation readiness, and executive and board reporting. Leads directors, other people leaders, and teams of audit, monitoring, compliance, and delegated oversight professionals, partnering with Compliance, Legal, Procurement, Operations, Enterprise Risk, and business owners to strengthen third party accountability and consistent enterprise execution.

Applicants may work remotely from home anywhere in the Continental United States. A Certified Internal Auditor (CIA) certification is required. The position requires a bachelor's degree in Business Management, Health Administration, or a related field, or equivalent work experience, and at least 10 years of progressively responsible experience in audit, compliance, enterprise risk, and/or third party risk management, including responsibility for complex, enterprise-scale programs. A master's degree and Certified in Healthcare Compliance (CHC) certification are preferred.

The annual pay range is $134,600 to $249,000. Centene offers a comprehensive benefits package that includes competitive pay, health insurance, a 401(k), stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible work arrangements. Pay and benefits may vary based on individual factors and program eligibility.

Requirements

• Bachelor's degree in Business Management, Health Administration, or a related field, or equivalent work experience.
• At least 10 years of 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.

Nice To Haves

• Master's degree.
• Certified in Healthcare Compliance (CHC) certification.

Responsibilities

• Establish the enterprise strategy, governance model, risk framework, and decision rights for third party risk management from a compliance perspective, aligning regulatory expectations, accreditation requirements, contractual obligations, enterprise risk appetite, and business objectives.
• Define and sponsor the multi-year operating roadmap, investment priorities, performance measures, scalable processes and technology, and organizational capabilities needed to mature the program and meet enterprise demand.
• Own the design and effectiveness of the enterprise third party risk management framework, including risk segmentation, due diligence standards, control expectations, quality assurance, and program effectiveness evaluation.
• Lead the enterprise delegated entity audit and monitoring program and direct risk-based audit plans for delegated entities, vendors, pharmacy benefit managers, third-party administrators, credentialing organizations, and other third parties.
• Oversee audit planning, execution, reporting, and validation, ensuring audit methodologies meet regulatory expectations and industry standards.
• Oversee auditing and monitoring of delegated operational, regulatory, clinical, pharmacy, claims, credentialing, utilization management, customer service, and other healthcare functions, including Medicare and Medicaid delegation oversight.
• Direct enterprise oversight of the third party lifecycle, establishing consistent requirements for due diligence, risk assessment, compliance monitoring, performance oversight, issue management, corrective action, termination or transition risk, and regulatory readiness.
• Direct audit issue identification, root cause analysis, corrective action validation, and closure. Establish thresholds for risk acceptance, issue classification, escalation, remediation, and reporting, and serve as the senior escalation point for material, systemic, or cross-business third party compliance risks.
• Chair enterprise governance forums and direct cross-functional decisions that strengthen third party risk transparency, accountability, and mitigation across Compliance, Legal, Procurement, Operations, Enterprise Risk, and business stakeholders.
• Oversee regulatory, contractual, and operational reporting from third parties. Lead organizational responses to CMS audits, external quality reviews, other regulatory examinations, delegated oversight reviews, external audits, and compliance assessments related to third party performance, including responses to significant findings and systemic control deficiencies.
• Advise executive leaders and business owners on regulatory change, emerging risk, third party concentration or dependency concerns, and significant control gaps, influencing enterprise priorities and corrective actions.
• Direct executive and board-level reporting on risk exposure, trends, material issues, program performance, and remediation status, translating complex information into recommendations that support enterprise decisions and risk prioritization.
• Lead directors, other people leaders, and teams of auditors, monitoring specialists, compliance analysts, and delegated oversight professionals. Establish organizational structure, resource planning, succession and talent strategies, leadership expectations, and accountability for consistent enterprise outcomes.
• Perform other duties as assigned.
• Comply with all policies and standards.

Benefits

• Health insurance
• 401(k)
• Stock purchase plans
• Tuition reimbursement
• Paid time off
• Holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules
• Competitive pay
• Additional forms of incentives may be included in total compensation, subject to eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Director