Manager, Risk and Compliance for Exxa Site!

Role Description:

• Conduct periodic tests on controls and report compliance to stakeholders
• Manage Frauds and drive Fraud Prevention activities
• Conduct regular risk assessment activities on all processes – client or internally-initiated changes and per defined frequency (example: New IT or Physical security guidelines, Outlier Analysis for trending fraud cases)
• Ensure all time readiness to internal and external audits
• Education requirements completion such as Data Privacy, Information & Cyber Security, Continuity, Fraud Prevention, & Physical Security Education, COEBC (new hires and existing)
• Risk Reporting and Communication
• Risk and Compliance team management and development
  Responsibilities:
• Lead and ensure that all internal and external audit related issues are tracked till closure
• Ensure function’s delivery is in line with operational and / or contractual obligations
• Manage escalations and implement action to avert future client escalations around compliance
• Seek to continually improve processes Integrity
• Provide on-going support, development, empowerment and positive reinforcement to floor on compliance
• Measure and manage the team to meet performance targets
• Communicate information in a timely, relevant and accurate manner to all stakeholders
• Ensure that all account compliance policies and procedures are adhered to
• Establish supporting processes for Risk and Compliance framework in the account
• Provide relevant internal and external reports as per the account requirements
• Analyze function’s output & security data identifying and highlighting trends to the management team & course correction (internal team output)
• Analyze security and compliance metrics identifying and highlighting trends to the management team & course correction
• Facilitate monthly calls with the Account Global team, share compliance findings, understand the root cause and collaborate for improvement
• Ensure that all internal and external audit related issues are tracked till closure
• Identify and drive continuous improvements and initiatives in the process
• Ensure that all internal customer/Employee queries are followed up on a timely basis
• Collaborate with internal teams, inter departments, cross functions across locations
• Be the Key contact for all compliance related queries and concerns from internal and external stakeholders

Operational Risks

1. Manage Fraud and drive Fraud Prevention activities across span

2. Conduct regular risk assessment activities on all processes – client or internally-initiated changes and per defined frequency (example: Outlier Analysis for trending fraud cases)

3. Review and update of FMEA document on a quarterly basis

4. Ensure testing of FMEA provisions are conducted per pre-determined frequency

Desired Skills:

• Excellent written and spoken English
• The ability to lead complex Fraud prevention initiatives, coordinate investigations, and individual task-level response activities across multiple teams and business units
• Detail oriented with excellent research, analytical and critical thinking skills
• Strong resource planning and organizational skillset
• Strong documentation, oral and written communications and interpersonal skills

Knowledge & Experience

• Must have experience leading/managing risk and compliance activities in a globally diverse org
• Experience required in identifying cyber or fraudulent/suspicious activity
• Must have experience presenting and/or communicating with Client’s senior representatives and Infosec team

Competencies:

• The ability to multitask, act under pressure and quickly identify and deal with priority matters under tight deadlines. Attention to detail is essential.
• The ability to handle multiple inquiries at any one time, often under considerable deadline pressure.
• The ability to work both independently and as part of a team.
• Will be responsible for overseeing and ensuring all clinical operations adhere to regulatory standards, and company policies. Role involves implementing compliance strategies to mitigate risks and will liaise with the onshore Regulatory Compliance on updates or changes in the US Healthcare regulations
• URAC Accreditation - involvement in URAC gap analysis and application process by coordinating documentation and reviews on compliance related standards.
• Regulatory Compliance - Ensure adherence to all relevant healthcare regulations and standards (HIPAA, CMS guidelines, etc)
• Stay up to date with regulatory changes and coordinates with onshore Regulatory Compliance to assess impact on the current operations
• Liaise with onshore Regulatory Compliance on state-specific licensure/registration before starting a clinical project based on scope of work, state regulations and client requirement
• Risk Management - Identify potential compliance risks and develop strategies to mitigate