Compliance (TPA)

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

• 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