- Location
- Quezon City, Bridgetowne Zeta, Philippines
- Workplace
- Onsite
- Type
- Full-time
- Department
- Legal
- Seniority
- Senior
- Closing date
- Today
- Source
- Workday
Description
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 Officers for all sites of the account
- Ensures efficiency in delivering performance expectations of the Compliance Officers
- 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 Officers
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 homework 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
COMPETENCY REQUIREMENTS:
With Basic Competency Level in ff.:
Product Knowledge
With Moderate Competency Level in ff.:
Computer Literacy Job Knowledge People Management/Team Orientation Expertise/Analytical Skills Product Knowledge Problem Solving Presentation Skills Coaching Process Improvement Performance Management Discipline Management
With Expert Competency Level in ff.:
Communication Skills (Spoken) Communications Skills (Written) Change Management Sense of Urgency Passion for Excellence Working in Team/Interpersonal Skills Work Organization Drive for Results/Execution Thriving in Change
OTHER REQUIREMENTS:
Reports to:
Compliance Manager, Senior Director or Program Head
Education and/or Experience:
Completed a 3 or 4-year university degree, preferably Mass Communication, Psychology, Education, or Management. Alternatively completed a 2-year university or a technical degree with 3+ years of Inbound Customer Service Call Experience
3 years call center experience
Certificates, Licenses, Registrations:
None
Work environment:
The work environment is professional office workplace. Business casual attire.
Physical demands:
Requires evening or graveyard work
May require overtime, weekend, or holiday work depending on business needs.
Work demands:
- Reports to office but may require work at home set-up
- The work environment consists of designated work area at home
- Home internet service provider with minimum of 10-15 mbps upload/download speed
- Smart mobile phone compatible with UEM Client usage
- Able to establish, implement and continuously improve the quality information security policies assigned to him/her
- Able to establish structure and procedures to protect classified information
- Able to report information security related incidents without any delay to the right authority. Example: All information-related incidents, losses, weaknesses and software/hardware malfunctions, breaches of confidentiality
- Actively participates during training, orientation and awareness programs pertaining to QISMS
Other Personal Attributes Required:
- Highly organized with strong attention to detail
- Ability to work independently and as part of a team
- Ability to work proficiently in a pressured environment
- Ability to handle confidential information
- Ability to communicate clearly with persons at a wide range of levels on sensitive matters
- Ability to identify and thoroughly investigate reporting discrepancies and determine the appropriate course of action (either resolution or higher-level review)
- Expert/proficient in MS Excel, PowerPoint, Word, SharePoint
- Ability to condense, refine, simplify, and communicate the purpose and significance of internal and external regulations
- Ability to develop operating policies and procedures based on business needs.
Location: