Associate Compliance Manager
Experience: Job Code: REQ-018341
Sagility
Quezon City
job Details
Job title
Associate Compliance Manager
About Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Job Description:
DUTIES & RESPONSIBILITIES:
Operational Compliance
- Responsible for day to day implementation of the account’s overall compliance program and ensuring that the organization’s activities satisfy all pertinent legal & regulatory requirements and that behavior in the organization meets the account’s House Rules and company’s Code of Conduct
- Responsible for reviewing and maintaining compliance policies & procedures
- Collaborates with other departments (e.g., Operations, Audit and Certification, WFM, Human Resources, etc.) to direct compliance issues to appropriate existing channels for investigation and resolution
- Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future
- Will review and interpret Federal and State laws and regulatory requirements, and monitor day to day implementation of policies and procedures
- With oversight from the company Audit and Certification Team, designs, implements, and monitors programs, policies, and practices to ensure that relevant business areas are following regulatory requirements
- Reports on a regular basis to the Group Heads and company Audit and Certification Team on the progress of implementation and assisting them in establishing methods to improve efficiency and quality of services
Privacy Officer Responsibilities
- Responsible for developing, implementing and maintaining the HIPAA Compliance Program within the Operations of the Health Care Account
- Responsible in validating the effective deployment of the organizational HIPAA policy
- Responsible in ensuring that privacy policies and procedures are communicated and understood by the team
- Responsible for effective incident management practices within the scope of HIPAA
- Responsible for identifying the risks associated with the identified assets and development of appropriate controls for its mitigation
- Assesses the adequacy and coordinates the implementation of specific information security within the area of responsibility
- Ensures protection of individual assets and ensure understanding of his team on the security processes and control
- Conducts periodic checks of people assets and check if these assets are properly accounted for
- Conducts regular updates on the organizational policies and procedures
- Report security incidents as quickly as possible and coordinates with the Privacy Officer for control effectiveness review and prevention plan
- Monitors significant changes in the exposure of information assets to major threats
- Encourage the members of his team to report any observed or suspected security weaknesses in, or threats to systems or services
Compliance Training
- Assists the company Audit and Certification Team to develop, coordinate, and participate in a multifaceted educational and training program that focuses on the elements of the compliance program
- Conduct training on various compliance topics and hold meetings where required
- Seeks to ensure that all appropriate employees and management are knowledgeable of and comply with pertinent federal and state standards
- Developing materials for distribution to all employees to enhance awareness of compliance activities, including posters
- Institutes and maintains an effective compliance communication program for the organization, including promoting (a) use of Incident Reporting and escalation to the Privacy Office; (b) heightened awareness of House Rules and Code of Conduct, and (c) understanding of new and existing compliance issues and related policies and procedures
People Management
- Oversees the performance of Compliance Officer/Specialist for all sites of the account
- Ensures efficiency in delivering performance expectations of the Compliance Officer/Specialist
- Manages administrative responsibilities for the Compliance Officers such as Discipline Management, Performance Management, Scorecard Maintenance, HR-related requirements, etc.
- Creates developmental plans to aid in career progression of the Compliance Officer/Specialist
Internal Auditing
- Conducts internal compliance review and monitors activities including periodic reviews of departments
- Responds to regulatory inquiries as a key point of contact
- Investigates and acts on matters related to compliance including internal investigations (e.g. responding to reports of problems or suspected violations) and any resulting corrective actions
- Responds to alleged violations of rules, regulations, policies, procedures, and Standards of Conduct by evaluating or recommending the initiation of investigative procedures. Develops and oversees a system for uniform handling of such violations
- Works closely with key managers to identify trends and implement corrective actions in regard to results of the internal audit reports
Work at Home Responsibilities
- Be familiar with and abide to all Sagility general security and Work @ Home security policies and procedures
- Be familiar with and abide by all client security policies and procedures required to protect customer data
- Maintain the security of the home work environment and protect the Sagility-provided assets, client system and data
- Ensure that all security related incidents are reported
- Shall work on the same internet connection that was tested during setup process. If changes are made to the current internet connection or router during the course of application or employment, employee will be required to notify the appropriate parties in advance and retest the connection to ensure the requirements are met
- Must immediately report system performance problems or downtime to his/her manager and the local IT-SPOC
General Safety and Security
- Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS)
- Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions
- Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH) as appropriate
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