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Bajaj Allianz General Insurance
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Circle Head-ILM-Health

Circle Head-ILM-Health

Bajaj Allianz General Insurance

3 - 7 years

20 - 25 Lacs

Hyderabad

Posted:2 months ago| Platform:

Apply

Skills Required

Data analysis Team management C Networking Resource allocation Audit report Strategic planning Risk management Monitoring Auditing

Work Mode

Work from Office

Job Type

Full Time

Job Description

PRINCIPAL ACCOUNTABILITIES

1. Planning and Preparation:

a. Establish an audit team with appropriate expertise and qualifications.

b. Review relevant regulations, guidelines, and company policies related to network empanelment.

c. Develop an audit plan, including the scope, objectives, timelines, and resource allocation.

d. Communicate the audit plan to relevant stakeholders and obtain necessary approvals.

2. Assessment of Existing Processes:

a. Evaluate the existing network empanelment policies and procedures.

b. Review the criteria and process for the selection, onboarding, and monitoring of third-party service providers.

c. Assess the due diligence and background checks conducted on service providers.

d. Verify compliance with regulatory requirements and industry best practices.

3. Sampling and Testing:

a. Select a representative sample of third-party service providers for testing.

b. Review the documentation and records related to the empanelment of the selected service providers.

c. Conduct on-site visits or virtual assessments, as applicable, to validate the information provided.

d. Test the effectiveness of controls and processes related to network empanelment.

4. Reporting and Recommendations:

a. Document the findings, observations, and areas for improvement in a comprehensive audit report.

b. Classify the findings based on their severity and impact.

c. Provide recommendations for addressing identified gaps and enhancing the network empanelment

process.

d. Present the audit report to relevant stakeholders and management for review and discussion.

MAJOR CHALLENGES

Working in a noncooperative and resistive environment may be stressful.
Experienced Network auditors with blend of investigative and analytical thinking are rare
Knowledge of General insurance industry is limited
Rural reach, extensive travelling, facing hostile situations
Handling data from multiple sources. Most of these sources use unique data collection methods and formats

DECISIONS

Shortlisting vendors (Auditors) and Financials payouts
Strategic planning & execution to deliver the maximum output from available resources / manpower.
Recommendation with regards to process enhancement & Implementation
Recommendations to the VH s on the new opportunities to investigate and prevent frauds / leakages.

INTERACTIONS

Internal Clients

Roles you need to interact with inside the organization to enable success in your day to day work

Head of Analytics
Head ILM, VH & ILM team members
Claim s, Underwriting, Business, Actuarial, Risk, Audit, HR, Legal, EW etc

External Clients

Roles you need to interact with outside the organization to enable success in your day to day work

Data Analytics Vendors
Private detective agencies
Field Investigation/Agency
Audit Firms

Other Dimensions

Business process improvement solutions (Leakage / Fraud proof )
Use of analytics towards Fraud Risk assessment

Educational Qualifications

MBBS / BE in Electronics / Mechanical / automobile / Electricals
Professional education in Fraud / Forensic studies / Law / Risk management / Audit

Work Experience

Knowledge of Audit, Data analysis, Fraud Risk Management,
A minimum of 10 Years of work experience. (with at least 5 years of Fraud risk experience)

Interview skills, Content writing skills, Team management skills

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