AVP Compliance I Dubai Financial Services Orient Insurance PJSC

Job Requisition ID: 180633

Established in the 1930s as a trading business, Al-Futtaim Group today is one of the most diversified and progressive, privately held regional businesses headquartered in Dubai, United A”rab Emirates. Structured into five operating divisions; automotive, financial services, real estate, retail and healthcare; employing more than 35,000 employees across more than 20 countries in the Middle East, Asia and Africa, Al-Futtaim Group partners with over 200 of the world's most admired and innovative brands. Al-Futtaim Group’s entrepreneurship and relentless customer focus enables the organisation to continue to grow and expand; responding to the changing needs of our customers within the societies in which we operate.

By upholding our values of respect, excellence, collaboration and integrity; Al-Futtaim Group continues to enrich the lives and aspirations of our customers each and every day.

Job Purpose

The Assistant Vice President - Compliance is responsible for supporting the VP-Compliance in ensuring the Company’s adherence to applicable regulatory requirements, with primary responsibility for compliance matters relating to health insurance and the requirements of the Dubai Health Authority (DHA) and Department of Health (DOH) in Abu Dhabi.

The role will also support VP- Compliance in the implementation and monitoring of the Company’s overall compliance framework and in handling other matters as assigned.

Key Responsibilities

• Health Insurance Regulatory Compliance – Primary Responsibility
• Review products, policy terms, underwriting, enrolment, claims, pre-authorization, reimbursement and complaints for regulatory compliance.
• Oversee compliance risks relating to provider networks, brokers, outsourcing partners and TPAs, including due diligence, contracts, service levels, data access and audit rights.
• Monitor laws, regulations, standards, circulars, notices and other requirements issued by the Dubai Health Authority (DHA) and the Department of Health in Abu Dhabi and ensure coordination with the above authorities.
• Coordinate with Health Insurance, Claims, Underwriting, Operations, IT and other relevant departments to ensure timely implementation of regulatory requirements.
• Maintain an updated register of applicable health insurance regulatory requirements and monitor the Company’s compliance with such requirements.
• Review health insurance policies and procedures from a regulatory compliance perspective.
• Support the preparation and submission of regulatory reports, responses, confirmations and other information required by the relevant health authorities.
• Coordinate and follow up on regulatory inspections, reviews, audits, observations and remediation actions relating to health insurance.
• Monitor regulatory deadlines and ensure that required actions and submissions are completed within the prescribed timelines.
• Escalate material compliance issues, regulatory breaches or implementation delays to the VP- Compliance.
• Promote fair customer outcomes and transparent disclosures in health insurance activities and monitor health insurance complaints from a regulatory compliance perspective.
• Provide compliance support in relation to financial crime controls and medical-fraud investigations; advise on privacy, consent, confidentiality, retention and health-data sharing.
• Compliance Monitoring and Assurance
• Execute risk-based reviews, report findings, establish accountable actions, validate closure and escalate material breaches.
• Maintain appropriate documentation and evidence demonstrating compliance with applicable regulatory requirements.
• Follow up with business units on agreed compliance remediation actions and report overdue or material matters to the VP- Compliance.
• Assist VP- Compliance in preparing compliance reports, maintain regulatory records, deliver targeted training and support enterprise-wide compliance initiatives.
• General Compliance Support
• Monitor compliance with applicable insurance laws, regulations, standards and regulatory circulars.
• Conduct regulatory gap assessments and support implementation of new regulatory requirements.
• Review internal policies, procedures, products, agreements and business initiatives from a compliance perspective.
• Support the preparation and updating of the Compliance Framework, Compliance Plan and related policies and procedures.
• Perform any other compliance-related duties assigned by the VP- Compliance.
  
  

Qualifications And Experience

• Bachelor’s degree in law, Finance, Business, Insurance, Healthcare Administration or a related field; relevant professional qualification preferred.
• Typically, 10–12 years’ relevant experience, including 5 years in a managerial or senior advisory role.
• Strong knowledge of UAE insurance regulation and practical medical-insurance experience.
• Experience with regulators, inspections, remediation and senior governance forums.
• Understanding of medical underwriting, claims, provider contracting, TPAs, coding, billing, outsourcing and health-data risks.
  
  

About Orient Insurance PJSC

Orient Insurance Company commenced operations in 1982 as a part of the reputed Al-Futtaim Group and has since recorded a progressively steady growth. The Company is counted among the leaders in the UAE insurance market. Orient Insurance Company has a paid-up capital of AED 500 Million which is the highest in the insurance industry in UAE. With head office in Dubai, the company serves its clientele through an extensive branch network in Jebel Ali, Abu Dhabi, Al Ain, Sharjah and Ras Al Khaimah in UAE, Muscat in Sultanate of Oman, Riyadh in Kingdom of Saudi Arabia and Bahrain.

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