II. Job Objective
III. To strengthen the control environment within the Claims function by leading Risk & Control Self-Assessment (RCSA), incident management, vendor/outsourcing risk governance, KRIs & operational loss reporting, audit/MSII management, access governance, and process automation oversight—while driving system enhancements to improve efficiency, compliance, and risk mitigation.
IV. Key Responsibility Areas
Key Result Areas Activities
1 Risk & Control Self-Assessment (RCSA)
Identify, assess, and document risks and controls; perform control testing; RCA for gaps; monitor remediation; ensure timely refresh; drive automation of manual controls.
2 Incident Management Manage incidents and near-misses; prepare RCA reports; track remediation
3 Vendor / Outsourcing Risk Management Due diligence per IRDAI guidelines; SLA monitoring; annual outsourcing risk reviews
4 KRIs & Operational Loss Reporting Monthly reporting with corrective actions; trend analysis
5 Thematic Reviews Identify control weaknesses; initiate process improvements
6 New Processes / Projects Risk identification and control log creation for recent initiatives
7 Audit & MSII Management Track MSII; support audits; ensure pre-audit readiness; reduce repeat observations
8 Policies & Contract Governance Timely review of policies; renewal of service contracts
9 Issue Closure Governance
Timely closure of RCSA issues, audit observations, InfoSec exceptions, etc
10 Process Automation Risk Oversight
Monitor automation risks; define mitigants
11 Data Quality Controls (DQC) Refresh reports; close exceptions
12 Access Governance Ensure appropriate system access; periodic reviews
13 Actionables & Governance Forums Close ICF, ORIG, Ops IT Sales meet, RAG action items
14 Claims Provisioning & Processing Oversight Monitor vulnerable areas; engage with Risk/GCE
15 Outstanding Client Monies Ensure timely clearance per reconciliation schedule.
16 System Enhancements Collaborate with IT and functio