Operational Compliance Officer

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.

DUTIES & RESPONSIBILITIES

Operational Compliance

• Responsible for the effective deployment of the organizational HIPAA policy
• Responsible for developing, implementing and maintaining the HIPAA Compliance Program within the account
• Monitors and reviews the effectiveness of the documented management system and ensures that all security procedures within the area of responsibility are carried out correctly to ensure compliance with security policies and standards
• 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 the team on the security processes and control
• Conducts periodic checks and reconciliation of people assets (User IDs, Voice IDs, Headcount and Access withdrawal) and check if these assets are properly accounted for
• Conducts periodic spot checks on implementation of Information Security and Floor Management (ISFM)
• Conducts periodic checks of the account to ensure that everybody in the program is complying with the rules set by the program
• Conducts regular updates on the organizational policies and procedures
• Conduct internal quality audits, report results, monitor actions, and ensure that all audited non-conformances are followed-up and closed
• Report security incidents as quickly as possible
• Monitors significant changes in the exposure of information assets to major threats
• Identifies the risks and appropriate controls associated with the identified assets
• Promotes visibility of business support for information security throughout the organization
• Encourage the members of his team to report any observed or suspected security weaknesses in, or threats to systems or services
• Perform regular process/compliance audits in adherence to set procedures and security policies, regulatory/contractual requirements, and the ISMS and QMS standards

Configuration Management

• Responsible to control all changes/revision requests for assigned program. Monitors changes that have been made on existing process and procedures and reviews the account’s/group’s shared folder

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.

1. Product Knowledge

With Moderate Competency Level in ff.

1. Process Improvement
2. Conflict Management
3. Discipline Management

With Expert Competency Level in ff.

1. Customer Service Orientation
2. Communication Skills (Spoken)
3. Communication Skills (Written)
4. Computer Literacy
5. Sense of Urgency
6. Job Knowledge
7. Passion for Excellence
8. Working in Teams / Interpersonal Skills
9. Work Organization
10. Analytical Skills
11. Reasoning Skills
12. Problem Solving

Basic knowledge on computer trouble shooting and connections preferred at a work at home environment.

OTHER REQUIREMENTS

Reports to

Senior Compliance Officer, Associate Compliance Manager, 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.

Certificates, Licenses, Registrations

N/A

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

• o The work environment consists of designated work area at home
• o Home internet service provider with minimum of 10-15 MBPS upload/download speed
• o Smart mobile phone compatible with authentication requirement as applicable

• 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

Job title

Operational Compliance Officer

Job Description

DUTIES & RESPONSIBILITIES

Operational Compliance

• Responsible for the effective deployment of the organizational HIPAA policy
• Responsible for developing, implementing and maintaining the HIPAA Compliance Program within the account
• Monitors and reviews the effectiveness of the documented management system and ensures that all security procedures within the area of responsibility are carried out correctly to ensure compliance with security policies and standards
• 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 the team on the security processes and control
• Conducts periodic checks and reconciliation of people assets (User IDs, Voice IDs, Headcount and Access withdrawal) and check if these assets are properly accounted for
• Conducts periodic spot checks on implementation of Information Security and Floor Management (ISFM)
• Conducts periodic checks of the account to ensure that everybody in the program is complying with the rules set by the program
• Conducts regular updates on the organizational policies and procedures
• Conduct internal quality audits, report results, monitor actions, and ensure that all audited non-conformances are followed-up and closed
• Report security incidents as quickly as possible
• Monitors significant changes in the exposure of information assets to major threats
• Identifies the risks and appropriate controls associated with the identified assets
• Promotes visibility of business support for information security throughout the organization
• Encourage the members of his team to report any observed or suspected security weaknesses in, or threats to systems or services
• Perform regular process/compliance audits in adherence to set procedures and security policies, regulatory/contractual requirements, and the ISMS and QMS standards

Configuration Management

• Responsible to control all changes/revision requests for assigned program. Monitors changes that have been made on existing process and procedures and reviews the account’s/group’s shared folder

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.

1. Product Knowledge

With Moderate Competency Level in ff.

1. Process Improvement
2. Conflict Management
3. Discipline Management

With Expert Competency Level in ff.

1. Customer Service Orientation
2. Communication Skills (Spoken)
3. Communication Skills (Written)
4. Computer Literacy
5. Sense of Urgency
6. Job Knowledge
7. Passion for Excellence
8. Working in Teams / Interpersonal Skills
9. Work Organization
10. Analytical Skills
11. Reasoning Skills
12. Problem Solving

Basic knowledge on computer trouble shooting and connections preferred at a work at home environment.

OTHER REQUIREMENTS

Reports to

Senior Compliance Officer, Associate Compliance Manager, 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.

Certificates, Licenses, Registrations

N/A

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 authentication requirement as applicable
• 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

Location

Quezon City, Bridgetowne ZetaPhilippines