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About the Role

Responsible for strengthening governance, compliance oversight, audit effectiveness, and operational excellence across Third-Party Administrators (TPA). This role will support the growing complexity of provider and partner management activities, including audit management, TPSA oversight, regulatory readiness, partner performance monitoring, operational governance, and continuous improvement initiatives. Work closely with internal stakeholders, TPAs, healthcare providers, brokers, and technology teams to ensure effective controls, service quality, and partner accountability. The role will also contribute to strategic initiatives involving provider integrations, data governance, process automation, and operational transformation.

Responsibilities:

Audit & Compliance Oversight

Plan, coordinate, and conduct provider, TPA, and partner audits.
Track audit findings and ensure timely closure of remediation actions.
Support Internal Control over Financial Reporting (ICFR), Internal Audit, Compliance reviews, and regulatory assessments.
Coordinate evidence gathering and audit documentation.
Monitor control effectiveness and identify potential operational or compliance risks.
Support TPSA reviews and related governance activities.
Maintain audit registers, action trackers, and governance documentation.

Partner & TPA Governance

Manage governance activities across Third Party Administrators and healthcare partners.
Monitor compliance with contractual obligations, service-level agreements (SLAs), and operational requirements.
Ensure timely submission and review of partner reports and performance metrics.
Track partner performance, issues, and remediation plans.
Conduct regular governance reviews with partners.
Review contractual terms and highlight areas requiring updates or enhancements.

Operational Governance & Risk Management

Drive issue management, escalation tracking, and resolution with internal and external stakeholders.
Monitor operational risks and implement mitigation measures.
Support policy, procedure, and governance framework reviews.
Improve documentation standards and audit trails.
Ensure adherence to internal governance and regulatory requirements.

Process Improvement & Transformation

Identify opportunities to improve operational efficiency and reduce manual processes.
Support automation and digitalisation initiatives across Provider Management workflows.
Participate in enterprise projects involving healthcare providers, TPAs, brokers, and technology partners.
Support implementation of new operational and service delivery models.
Develop dashboards, reporting packs, and management information for governance tracking.

Stakeholder Management

Serve as a liaison between AIA and healthcare partners, TPAs, brokers, and internal stakeholders.
Coordinate across Operations, Compliance, Legal, Technology, Sales, and Customer teams.
Support partner governance meetings and executive reporting.
Facilitate communication and follow-up actions arising from audits, reviews, and operational issues.

Consultant, Provider Management