I. General Information
Role: Designation: Deputy ManagerDepartment/Function: ClaimsCareer Level: Direct Reporting: NAIndirect Reporting:# of Direct Reportees: NA# of indirect Reportees: Highest Education: Graduate
Experience:
II. Job Objective

1. 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 oversightwhile driving system enhancements to improve efficiency, compliance, and risk mitigation.

IV. Key Responsibility Areas
#Key Result AreasActivities1Risk & 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.2Incident ManagementManage incidents and near-misses; prepare RCA reports; track remediation3Vendor / Outsourcing Risk ManagementDue diligence per IRDAI guidelines; SLA monitoring; annual outsourcing risk reviews4KRIs & Operational Loss ReportingMonthly reporting with corrective actions; trend analysis5Thematic ReviewsIdentify control weaknesses; initiate process improvements6New Processes / ProjectsRisk identification and control log creation for current initiatives7Audit & MSII ManagementTrack MSII; support audits; ensure pre-audit readiness; reduce repeat observations8Policies & Contract GovernanceTimely review of policies; renewal of service contracts9Issue Closure Governance
Timely closure of RCSA issues, audit observations, InfoSec exceptions, etc10Process Automation Risk Oversight




Monitor automation risks; define mitigants
11Data Quality Controls (DQC)Refresh reports; close exceptions12Access GovernanceEnsure appropriate system access; periodic reviews13Actionables & Governance ForumsClose ICF, ORIG, Ops IT Sales meet, RAG action items
14Claims Provisioning & Processing OversightMonitor vulnerable areas; engage with Risk/GCE15Outstanding Client MoniesEnsure timely clearance per reconciliation schedule.16System EnhancementsCollaborate with IT and functional teams to identify, propose, and implement system enhancements for claims processing, automation, and risk mitigation

V. Key Performance Indicators
Financial

- System Enhancement ROI: Reduction in manual interventions and cost savings from implemented enhancements.
- Claims Provisioning Accuracy: Variance within defined actuarial/finance thresholds
- Outstanding Client Monies: % reduction in aged outstanding items (>30 days) within 2 quarters.
- Audit Observation Reduction: YoY reduction in audit observations (impacting financial risk)
- Loss Incidents: Zero high-severity financial loss incidents due to control failures

Customer

- Timeliness of Regulatory & Internal Reporting: 100% reports delivered within SLA.
- Vendor SLA Compliance:



100% adherence to service levels for outsourced vendors.
- Incident Management: RCA and remediation completed within SLA; zero repeat incidents impacting customer experience.
- Access Governance: 100% timely provisioning/deprovisioning to avoid service disruption.

Process

- RCSA Completion: 100% refresh and control testing per schedule.
- Automation Coverage: % of manual controls automated (target 50% annually).
- System Enhancements Delivered: Number of enhancements implemented per quarter.
- DQC Exception Closure: 100% closure within 7 business days.
- Actionable Closure: on-time closure of ICF, ORIG, Ops IT Sales meet, RAG items.
- Audit & MSII Management: Zero repeat observations; 100% MSII tracked and closed.
- KRIs & OpLoss Reporting: Monthly reports delivered by T+5 days with corrective actions logged

VI. Major Challenges

VII. Role Context

VIII. Management & Leadership of Regulatory, Compliance & Operational Risk
IX. Observation of Internal Controls

Disclaimer:

- The information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job, nor are they intended to be an all-inclusive list of the skills and abilities required to do the job.
- The number of direct and indirect reportees may change depending upon the criticality of the role as well as business requirement.
- Management may, at its discretion, assign or reassign duties and responsibilities to this job at any time.
- The duties and responsibilities in this job description may be subject to change at any time due to reasonable accommodation or other reasons.

📌 Operations Manager-IT -Claims-Life Insurance GGN 12 L (Delhi)
🏢 Placewell Careers
📍 Delhi