JOB SUMMARY
T he Sr. Compliance Analyst assists in communicating the importance of compliance and the Compliance program to Wipro HealthPlan Services (HPS) staff, which includes promoting increased awareness of the Corporate Ethics and Compliance Program, understanding of new and existing compliance issues and related policies and procedures, and importance of internal compliance audits and assessment. In the performance of the respective tasks and duties adhere to all policies and procedures, department specific rules, annual educational requirements, Code of Conduct, client contract requirements, and all other federal and state laws. This role performs special projects as requested by the Compliance and Privacy Officer, Executive Management and/or the Corporate Compliance Committee. This role is responsible for data analysis, developing reports, trending, and conducting due diligence, and will interact with subject matter experts within the Information Security, Operations, and IT teams, to identify and analyze data elements, report findings or conclusions, and suggest approaches or factors for enhancing compliance risk models and processes. Duties include but are not limited to: Monitoring and oversight of the Compliance Program; testing and evaluation of internal control systems; adherence to established policies and procedures; assurance that adequate controls are in place; and compliance with various regulations .
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ESSENTIAL JOB FUNCTIONS/DUTIES
• Participate in the development of compliance training and specialized training
• Assist in the implementation and establishment of the Corporate Compliance Program
• Provides guidance, information and/or services to various operational areas of HPS to ensure ongoing
• regulatory compliance
• Active participant in regulatory and compliance related conference calls and meetings
• Actively promotes a culture of compliance and ethical behavior
• Provides research of State and Federal regulations as requested by various operational areas of HPS
• Knowledge Management systems and ensure that processes and procedures are being followed
• Assist with maintenance of Regulatory & Compliance SharePoint site including resource library
• Maintenance of the compliance evidence and workpapers in SharePoint and Shared folders
• Develop and execute audit programs for specific audit projects throughout the year. Actively manage workflow and complete tasks in accordance with set deadlines and expectations.
• Evaluate compliance with Company policies, i.e. code of ethics and standards of conduct, agency sales, contractual obligations and governmental regulations, etc.
• Prepare audit reports and work papers, communications with team members, assist with audit interviews/
conferences, assist in quarterly audit update, ensure accuracy of work performed and maintain efficiency of operations.
• Develop understanding of the function of all departments within HPS and its operating units and how they relate to each other.
• Assist in ad hoc projects as assigned .
• Federal Regulations and Corporate Compliance Program
• Determine the Root Cause of failure in case of any incident and work to put in place Corrective and Preventive measures
• Identify risk & compliance issues and assisting in mitigating risks. Define Risks That Matter with each Process, along with the Process Management, Focus on "Risk That Matters" - RTM and develop action plans for mitigations
QUALIFICATION REQUIREMENTS
• Related Work Experience: 4 years
• Experience in evaluation, documentation and improvement of business internal controls, including Policy and
• Procedure development, process work flows, and standard operating procedures.
• Prior experience with Compliance oversight, vendor oversight and monitoring activities preferred.
- Exceptional analytical, organizational and data management skills
- Ability to focus on multiple projects and time-sensitive initiatives
- Experience in leading, managing and facilitating critical projects.
- Self-starter and the ability to work independently with minimal supervision
- Strong strategic thinking skills with the ability to work in a leadership role
- Exhibits an awareness and understanding of positive ethical and moral principles consistent with the mission and values of the organization.
- Experience in Policy and Procedure development, process work flows, and standard operating procedures.
- Prior Compliance experience preferred, including conducting investigations, performing risk assessments, and monitoring oversights.
- Excellent verbal and written communication skills with the ability to convey pertinent information effectively and comprehensively.
- Independent work planning, project management and time management skills.
- Strong ability to prioritize and organize effectively in a multi-tasking environment.
- Strong skills in Microsoft Office applications (e.g., Excel, PowerPoint, Access, Word, Visio, etc.)
EDUCATION REQUIREMENTS
• Preferred Education Level: Bachelor's Degree
LICENSING/CERTIFICATION REQUIREMENTS
P HYSICAL REQUIREMENTS
• Working conditions are normal for an office environment.
• May be subject to interruptions.
• Minimal physical exertion.
- Required to work computer.