Compliance (Tpa)

Maintain a constructive relationship with Bupa Arabia TPA key regulators for an effective regulatory risk management
- Establish an operating consistency with Bupa Arabia TPA regulators (mainly SAMA and CCHI) by sharing updates, seeking clarifications/advice and reporting market trends
- Ensure all regulatory queries/requests for information are addressed
- Maintain records of all interactions with regulators
- 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
- 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.
- Manage Compliance Monitoring assignments by establishing and managing the scope and approach to the work program 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
- 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
- Design and updated the AML & CFT questionnaire for correspondent banks or any third party
- Maintain and update sufficient record of all cases including laws, rules and regulations in AML/CTF database

**Skills**:

- 5 years (not less than 3 years within the insurance industry and compliance area)
- 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 organized approach to planning, implementation and record keeping
- High level of attention to detail
- Take initiative and proactive approach to problem solving
- Time management skills
- Professional Certificate(s) in Compliance - CCO Certificate is a plus