Director, Operations Regulatory and Accuracy Assurance Oversight(Preferred Exper

Job Summary: The Director, Operations Regulatory and Accuracy Assurance Oversight is responsible for representing and leading regulatory, compliance, and accuracy assurance activities on behalf of the Operations division. This senior-level leader serves as the Operations liaison to enterprise Regulatory, Compliance, Audit, and other assurance partners; leads independent evaluation of operational outcomes and processes for accuracy; and advances automation-enabled controls and operational efficiencies. Essential Functions: Serve as the Operations liaison and coordinate with enterprise Compliance, Regulatory, Legal, and Audit leaders on behalf of Claims, Configuration, Enrollment, Payment Integrity, Grievance & Appeals, Encounters, and Provider & Member Data. Represent Operations internally and externally with regulators and auditors, coordinating responses, requests, audits, investigations, and remediation with the appropriate enterprise partners. Partner with operational leaders and Regulatory and Legal teams to interpret and implement laws, regulations, guidance, contracts, and related requirements. Lead Operations accuracy assurance, including risk-based and independent auditing of operational outcomes and processes; identify root causes, report findings and trends, and oversee corrective actions through sustainable resolution. Establish and advance automated auditing capabilities, including agentic approaches, to expand testing coverage, improve timeliness, and str