Current jobs related to Sr. Director, Third Party Compliance Oversight - Boston - Commonwealth Care Alliance

  • Global Director of Third Party Risk Management

    4 days ago

    Boston, Massachusetts, United States Liberty Mutual Full time

    Job DescriptionAt Liberty Mutual, we are seeking an experienced professional to fill the role of Director, Global Third Party Risk Management. This position provides leadership for the current Third Party Risk Program in the US and oversees the efforts to include Global regulatory requirements for all Liberty Mutual international locations.Key...

  • Director, Global Third Party Risk Management

    4 days ago

    Boston, Massachusetts, United States The Liberty Mutual Foundation Full time

    Job SummaryThe Director, Global Third Party Risk Management will lead the development and implementation of a comprehensive Third Party Risk Management program across the organization. This role will be responsible for managing a team of risk analysts and ensuring that all third-party vendors are properly assessed and monitored for risk.Key...

  • Director, Global Third Party Risk Management

    4 days ago

    Boston, Massachusetts, United States Liberty Mutual Full time

    About the Role:This is an exciting opportunity for an experienced Third Party Risk Management professional to join Liberty Mutual as the Director, Global TPRM. The successful candidate will lead the TPRM Office and be responsible for the current Third Party Risk Program in the US, as well as leading efforts to include Global regulatory requirements for all...

  • Head of Cyber Third Party and Risk Management

    2 months ago

    Boston, United States MASSMUTUAL Full time

    Overview: We are seeking an experienced and strategic leader to join our organization as the Head of Cyber Third Party and Risk Management. In this critical role, you will be responsible for overseeing and enhancing our third-party cyber risk management program, governance, security awareness and training, and ensuring the security of our business...

  • Senior Compliance Analyst

    3 weeks ago

    Boston, United States Ameriprise Financial Full time

    We have an exciting opportunity as a Sr. Compliance Analyst at Ameriprise! In this role, you will perform Compliance monitoring reviews covering a variety of regulatory topics and perform oversight of internal operations and outsourced providers to our global investment management businesses. Come apply today!Key ResponsibilitiesConducting regional and...

  • Associate Director, Global GxP Compliance Lead

    5 days ago

    Boston, Massachusetts, United States Vertex Pharmaceuticals Full time

    Job SummaryThe Associate Director, Global GxP Compliance is responsible for overseeing global compliance programs and processes across GxP vendors. This position provides compliance oversight of all GxP processes outsourced to third-party vendors associated with development and commercialization of Vertex products.Key ResponsibilitiesProvide compliance...

  • Global GxP Compliance Director

    5 days ago

    Boston, Massachusetts, United States Vertex Pharmaceuticals Full time

    Job DescriptionThe Associate Director, Global GxP Compliance, is a critical role within the Vertex Quality Assurance Organization. This position is responsible for overseeing global compliance programs and processes across GxP vendors.This role provides compliance oversight of all GxP processes outsourced to third-party vendors associated with development...

  • Associate Director, US Ethics

    1 month ago

    Boston, United States Servier Full time

    About Servier Pharmaceuticals At Servier Pharmaceuticals, we are dedicated to bringing the promise of tomorrow to the patients we serve. We are a commercial stage, privately held pharmaceutical company, based in the US. Currently, we have four medicines approved in acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and cholangiocarcinoma...

  • Associate Director, Global GxP Compliance

    1 week ago

    Boston, Massachusetts, United States Vertex Pharmaceuticals Full time

    Job SummaryVertex Pharmaceuticals is seeking an experienced Associate Director, Global GxP Compliance to join our team. As a key member of the Global Quality Compliance group, you will be responsible for leading global compliance programs and processes across GxP vendors.This role will provide compliance oversight of all GxP processes outsourced to...

  • Associate Director, CMC Compliance

    1 month ago

    Boston, United States Vertex Pharmaceuticals Full time

    Job Description General Summary: The Associate Director, CMC Compliance is responsible for proactively and comprehensively monitoring vendor quality and compliance risk for vendors participating in GxP regulated environments across product modalities. This position is responsible for developing, maintaining, and disseminating vendor data and analytics,...

  • Third Party Cyber Risk Management Security Analyst- AVP

    1 month ago

    Boston, United States State Street Corporation Full time

    Who we are looking for State Street's Global Cyber Security (GCS) Third Party Cyber Risk Management (TPCRM) program seeks to mitigate a variety of third-party information security risk in accordance with the Bank's cyber risk appetite. Through a framework that addresses policy, process, operations, people, and technology, GCS protects our infrastructure,...

  • Associate Director, Vivarium Oversight

    1 month ago

    Boston, Massachusetts, United States BioSpace, Inc. Full time

    Job Title: Associate Director, Vivarium OversightWe are seeking an experienced Associate Director, Vivarium Oversight to join our team at BioSpace, Inc. This role will oversee the daily activities of the animal care and husbandry contractors and ensure that all activities adhere to and comply with institutional Standard Operation Procedures and the...

  • Associate Director, Vivarium Oversight

    4 weeks ago

    Boston, Massachusetts, United States BioSpace, Inc. Full time

    Job Title: Associate Director, Vivarium OversightWe are seeking an experienced Associate Director, Vivarium Oversight to join our team at BioSpace, Inc. This role will oversee the daily activities of the animal care and husbandry contractors and ensure that all activities adhere to and comply with institutional Standard Operation Procedures and the...

  • Compliance FDR Vendor Oversight Manager

    4 weeks ago

    Boston, Massachusetts, United States Talents Without Frontiers Full time

    Job Details:This position is responsible for ensuring the effective oversight of compliance programs for Medicare First Tier Downstream and Related Entities (FDRs) and identified vendors. The role involves reviewing RFP responses for regulatory compliance, including General Compliance Auditing, Monitoring, and HIPAA.Key Responsibilities:Coordinate the...

  • Compliance FDR Vendor Oversight Manager

    1 month ago

    Boston, Massachusetts, United States Talents Without Frontiers Full time

    Job Details:This position is responsible for ensuring the effective oversight of compliance programs for Medicare First Tier Downstream and Related Entities (FDRs) and identified vendors. The successful candidate will have a strong understanding of federal and state regulatory requirements and will be responsible for reviewing RFP responses for regulatory...

  • Director of Quality Oversight

    5 days ago

    Boston, Massachusetts, United States Vertex Pharmaceuticals Full time

    Quality Oversight and AssuranceThe Director of Quality Oversight will be responsible for ensuring the quality of cell and genetic programs throughout clinical development, commercialization, product launch, and post-approval lifecycle management activities. This includes setting and maintaining overall quality strategies, product project management in...

  • Oracle PLM Technical Lead

    2 weeks ago

    boston, United States Edge Staffing Full time

    Position: Oracle PLM Technical Lead (NO THIRD PARTIES PLEASE)Type: ContractLocation: Full remote-United States-with some travel to work onsite with client REQUIREDDuration: 9-12 months expected durationOur client seeks an Oracle PLM Team Lead to work with the senior functional resource and handle the technical aspects of their Oracle Product Life Cycle...

  • Oracle PLM Technical Lead

    2 weeks ago

    Boston, United States Edge Staffing Full time

    Position: Oracle PLM Technical Lead (NO THIRD PARTIES PLEASE)Type: ContractLocation: Full remote-United States-with some travel to work onsite with client REQUIREDDuration: 9-12 months expected durationOur client seeks an Oracle PLM Team Lead to work with the senior functional resource and handle the technical aspects of their Oracle Product Life Cycle...

  • Oracle PLM Technical Lead

    2 weeks ago

    Boston, United States Edge Staffing Full time

    Position: Oracle PLM Technical Lead (NO THIRD PARTIES PLEASE)Type: ContractLocation: Full remote-United States-with some travel to work onsite with client REQUIREDDuration: 9-12 months expected durationOur client seeks an Oracle PLM Team Lead to work with the senior functional resource and handle the technical aspects of their Oracle Product Life Cycle...

  • Oracle PLM Technical Lead

    2 weeks ago

    Boston, United States Edge Staffing Full time

    Position: Oracle PLM Technical Lead (NO THIRD PARTIES PLEASE)Type: ContractLocation: Full remote-United States-with some travel to work onsite with client REQUIREDDuration: 9-12 months expected durationOur client seeks an Oracle PLM Team Lead to work with the senior functional resource and handle the technical aspects of their Oracle Product Life Cycle...

Sr. Director, Third Party Compliance Oversight

2 months ago

Boston, United States Commonwealth Care Alliance Full time
Why This Role is Important to Us:

The Senior Director, Third Party Compliance Oversight reports directly to the SVP, Corporate Compliance & Ethics and Risk Operations, and leads the Third-Party Compliance Oversight department for Commonwealth Care Alliance (CCA). This position effectively leads our Third-Party Compliance Oversight programs which includes monitoring and evaluating the performance of delegated third parties according to CMS, federal, and state requirements in a manner that continually supports the business and operational areas.


What You'll Be Doing:
  • Strategically leads the Third-Party Compliance Oversight Department staff that perform compliance oversight and monitoring of delegated third parties including Medicare FDR; Duals/SNP; and Medicaid/LTSS programs.
  • Coordinates and reviews work completed by Third-Party Compliance staff including risk assessments, compliance program reviews, pre-delegation screenings and various items for accuracy and completeness.
  • Manages and monitors third parties against CMS, contractual, federal, and state requirements.
  • Ensures strategic and operational partnership and collaboration with the business and operational areas, as well as with GRC teams to leverage cross-departmental synergies and efficiencies.
  • Maintains strong communication and working relationships with internal and external business partners.
  • Develops clear, effective, and timely reports and updates for senior management and/or the Board regarding Third-party Oversight Compliance Program effectiveness, initiatives, and issues, including all relevant metrics, dashboards and information.
  • Reviews, researches, interprets and summarizes federal and state regulations and ensures timely training of key personnel impacted by new or changed regulations.
  • Facilitates and participates in team and committee meetings, providing ideas and suggestions to ensure compliance standards are met.
  • Assesses, investigates, and resolves issues to ensure customer satisfaction.
  • Maintains a positive work environment and supports the experience, skill, knowledge, and growth opportunities of all employees.
  • Coordinates and performs ongoing monitoring of third-party activities to ensure compliance.
  • Works closely with the Governance, Risk & Compliance (GRC) teams (Medicare, Medicaid, Privacy, Fraud, Waste & Abuse) for dissemination of new or revised requirements applicable to the delegated third-party.
  • Oversees, develops, and maintains reporting and metrics for delegated third-party activities.
  • Ensures timely receipt of accurate and complete reporting for all regulatory and contractually required reports for delegated third parties.
  • Oversees the process for completing Third-Party Pre-Qualification/Delegation Assessments.
  • Oversees the process for Third-Party Annual Attestations.
  • Oversees and conducts risk assessments for each third-party.
  • Develops and maintains oversight document evidence related to compliance oversight in preparation for state, federal and regulatory audits.
  • Monitors and audits delegated third parties to ensure compliance with state and federal requirements.
  • Executes compliance monitoring plans to monitor delegated third parties to meet regulatory oversight and compliance requirements.
  • Oversees, develops, assesses, and adapts clear and effective remediation and corrective action initiatives, protocols, and controls to ensure proper and timely compliance.
  • Stays abreast of changing industry requirements and regulations, including all relevant laws, rules, contractual agreements, industry standards, company practices and initiatives.
  • Provides clear and effective reports to the relevant business, functional and operational areas, as well as other internal/external stakeholders, regarding new laws, regulations, contractual requirements, industry standards and best practices.
  • Performs other duties as assigned.

What We're Looking For:

Demonstrate integrity by working with passion, commitment, and honesty, acting in the best interests of colleagues and members. Approach work in a collaborating and caring manner interacting with insight, sincerity, and compassion. Demonstrate accountability by delivering on commitments, owning mistakes as well as successes, and contributing to an empowering environment where the focus is on solving problems and learning from errors. Recognize and respect diversity in all forms. Strive for excellence in the fulfillment of CCA's mission through quality, innovation, and continuous learning. Demonstrate initiative, flexibility, and openness to change. Represent CCA and its clinical affiliates with professionalism. Keep current and proficient with necessary skills and knowledge. Self-identify training and development needs relevant to work area and responsibilities. Adhere to all applicable compliance requirements including but not limited to:

  • Complete required compliance training in a timely manner
  • Review Code of Conduct at least annually and promote and enforce CCA's Code of Conduct
  • Promote and enforce CCA's compliance program
  • Adhere to CCA's Policy & Procedures
  • Promptly, in good faith, report any instances of suspected fraud, waste and abuse; suspected privacy and/or security incidents; or any compliance concerns identified
  • Ensure confidentiality of member and company proprietary information is maintained

Required:

  • Bachelor's Degree
  • Minimum of 8-10 years delegation oversight, vendor management, health insurance government products and programs (Medicare, Duals/SNP, Medicaid, LTSS), and/or compliance experience required, on the insurance (payor) side.
  • Minimum of 5 years of work experience in a managerial/leadership role managing a team directly.
  • Strong subject matter expertise and knowledge of all relevant laws, regulations, contractual requirements, industry standards and best practices required.
  • Strong acumen and understanding of healthcare, health insurance and managed health care industries and organizations required.
  • Strong partnership-, relationship-, consensus- and coalition-building skills required.
  • Strong emotional intelligence and self-awareness required.
  • Strong executive polish and presence required.
  • Strong strategic, business, operational, and leadership mindset and skills required. Highly consultative and partnership-oriented in approach.
  • Strong ethical compass and integrity capital required.
  • Excellent organizational, analytical and problem-solving skills, as well as oral, listening and written communication skills, required.
  • Strong ability to synthesize complex requirements and clearly and concisely articulate the relevant points.
  • Strong program and project management skills and experience required.
  • Ability to influence at all levels of the organization, including executive management; the Board; regulators; employees; customers; partners and vendors.
  • Strong and reliable judgment and discretion required.
  • Strong ability to independently and self-sufficiently identify and navigate various operational issues.

Desired:

  • Relevant graduate degree (e.g., Juris Doctor or master's degree in a related field)
#J-18808-Ljbffr