Compliance (TPA)

Job Description

Role Purpose:

• To adequately manage the relationships with Bupa Arabia TPA regulators.

• To fulfil the duties of “Second Line of Defence (LoD)” effectively and efficiently in sync with Bupa Arabia’s TPA governance framework.

• To ensure that Bupa Arabia TPA manages its regulatory risk, compliance and conduct responsibilities to agreed and approved appetites.

To support in managing the Speak-up program to ensure that the Speak-up policy is complied with and that it operates effectively and consistently across Bupa Arabia TPA

Regulatory Relationship Management:

• Maintain an open, transparent and constructive relationship with all of Bupa Arabia TPA key regulators, as key part of effective regulatory risk management.

• Establish an operating rigor with Bupa Arabia regulators (mainly the Insurance Authority), through visits, conference calls, forums, workshops, etc.… aiming at sharing updates, seeking clarifications/advice and reporting market relating trends.

• Designate individual(s) who are responsible for communications with regulators.

• Make sure that all regulatory queries/requests for information are responded to in a timely manner.

Adequately maintain records of all interaction with regulators including meetings, workshops, and correspondence

Regulatory Compliance Policies & Processes:

• Identify regulatory requirements that apply to Bupa Arabia TPA businesses

• Design and review policies, procedures, and requirements to oversee compliance with local regulatory requirements

• Ensure Bupa Arabia TPA implements robust governance to oversee regulatory compliance across its businesses

• Identify relevant regulatory changes and communicate them with management

• Incorporate the methodology for mapping applicable regulatory requirements to Bupa Arabia TPA’s internal policies, processes, and controls

• Manage the procedures outlining the escalation paths for regulatory incidents according to their material

Regulatory Risks:

• Assessment of the policies and procedures of Bupa Arabia TPA against any regulatory requirements or risks

• Periodical review of Bupa Arabia TPA contracts against regulatory requirements related to regulatory outsourcing or regulatory risks

• Ensure that regulatory licenses are proactively renewed

• Assist the Customer Service Department in handling the TPA customer complaints received and resolved and communicate to corresponding Bupa Arabia TPA stakeholders.

• Report any regulatory developments which impact Bupa Arabia TPA’s businesses and assess the impact on Bupa Arabia TPA and readiness to comply with the new regulatory requirements

Compliance Monitoring:

• Manage Compliance Monitoring assignments by establishing and managing the scope and approach to the work programme and resources assigned for the relevant process areas

• Identify and review control weaknesses and deficient conditions, recommend corrections for unsatisfactory conditions

• Manage follow-up processes covering all recommendations and ensure that management actions have been effectively implemented and the risk is contained

• Prepare and issue the final Monitoring report including the improvement program to management

AML and Combating Terorisim Financing:

• Develop and update an AML and combating terrorism financing policy and reporting procedures

• Review and evaluate reports concerning large and extraordinary suspicious operations

• Advice and assist the TPAs business in issue related to AML and Sanction risk

• Review divisional and departmental policies and procedures with regards to money laundering and combating terrorism

• Apply the policies of a Risk Based Approach for customers, products, services and channels risk assessment from AML/CTF perspective including “Politically Exposed Persons”

• Manage cases related to conflict of interest and Business courtesies, enumerating sanctions issued by the United Nations Security Council and local sanctions issued by local authorities that apply to the TPA business

• Design and updatd the AML & CFT questionnaire for correspondent banks or any third party

• Maintain and update sufficient record of all cases inculding laws,rules and regulations in AML/CTF database

Skills

• Strong knowledge in insurance, preferably medical insurance

• Strong knowledge of TPA companies is preferred

• Strong written and verbal communication skills

• Able to work with diverse groups of staff, regulators and clients

• Methodical and organised approach to planning, implementation and record keeping

• High level of attention to detail

• Take initiative and proactive approach to problem solving