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Senior Operational Risk Officer – Consumer Bank
Location
Ohio
Posted
80 days ago
Salary
$96K - $181K / year
Seniority
Senior
Job Description
Senior Operational Risk Officer – Consumer Bank
KeyBank
• Work directly with the lines of business (LOBs) to identify and assess risks, review and challenge risk assessments, provide input over controls and testing, advise on and monitor remediation activities and create reporting, ensuring line of business alignment within the Operational Risk program and framework. • Responsible for primary execution of Operational Risk oversight and help guide and influence implementation of operational policies and/or procedures to mitigate risk within appetite. • Responsible for assisting with the ongoing development and implementation of the Major Line of Business (LOB) Operational Risk teams strategic plan to accomplish its Annual Operational Risk objectives, to include among others: the development and implementation of Operational risk policies and procedures; assessment, monitoring and testing; establishment of line of business accountability and escalation and reporting processes. • Responsible for ongoing development and implementation of operational risk management topics, including such things as being the subject matter expert on operational risk activities associated with risks, controls, testing, remediation and reporting. • Actively participate in broad risk management oversight of assigned LOB. Provide direction and deliver training to line of business personnel, Risk Management staff and others on Operational Risk best practices and other relevant industry best practices. • Monitor and assess new or amended legal and regulatory requirements as they relate to the Consumer Bank. • Responsible for review and challenge of LOB policies and procedures to ensure that they are consistent with current applicable rules, regulations, laws and are effective in mitigating related risks. • Work with the LOB to ensure the ongoing development and enhancement of risk assessments, testing, monitoring and associated plans. • Provide authoritative and consultative advice and support to management utilizing independence yet providing pro-business solutions. • Analyze and provide feedback around risks associated with the offering of new and/or enhanced products, services, processes, business initiatives and outsourced third party activities. • Responsible for proactively anticipating and responding to changes in regulations, rules and/or laws; assessing the impact of any change to the business areas and assisting them in responding to such changes. • Accountable for ensuring that line of business policies and procedures are consistent with current applicable banking and securities rules, regulations, and laws. • Respond to internal and external audits, exams and requests for information and provide review & challenge of any line of business responses to internal and external audits. Assist in the evaluation of audit and examination findings and implementation of corrective action and needed responses. • Assist in the response to ongoing regulatory and legal inquiries and investigations. • Develop and maintain positive working relationships with internal clients, staff, peers, other risk partners, and LOB senior management. • Maintain relationships with industry peers and regulatory bodies. • Escalates promptly to appropriate senior management or appropriate risk committee any material breaches of applicable laws, rules, policies or standards with actual or potential operational risk impact, and necessary correction action. • Acts as Operational Risk Subject Matter Expert on any assigned Subcommittees and/or Working Groups. • Provide leadership and/or support on special projects, as assigned. • Proactively works with assigned business unit management to identify and assess the operational risks associated with business activities, ensuring alignment with the Corporate Operational Risk Framework, including: • Advising LOBs on operational risks and controls and key risk indicators. • Advising LOBs on operational risks related to new products and/or services and business initiatives. • Advising LOBs on operational risks related to outsourced third party activities. • Providing reporting to executives LOB partners on a periodic basis. • Conducts review and challenge activities and escalation, including independent testing as required. • Manage 2nd LOD requirements related to the Governance, Risk & Compliance application and Risk Assessment Processes. • Other duties as assigned.
Job Requirements
- Bachelor’s degree in business, finance, or economics or commensurate experience is required.
- Minimum of 5 years industry experience, ideally within Operational Risk, Enterprise Risk, or line of business risk functions.
- Proven ability to work collaboratively and productively across the organization
- Outstanding active listening skills
- Ability to effectively manage competing priorities within a fast-paced environment, including supporting client workflows and transactions while ensuring sound business practices are applied to mitigate risk within appetite
- Demonstrated ability to work with internal and external auditors and regulators.
- Ability to effectively communication and influence at all levels of the organization
- Ability to think strategically coupled with the ability to drive to execution
- Ability to foster and encourage collaboration between multiple risk disciplines
- Ability to view risk holistically within a dynamic, fast paced team environment
- In-depth practical knowledge of internal controls, risk assessments and operational and compliance processes, and applicable techniques for implementation of regulatory, compliance and legal requirements and operational processes.
- Strong leadership and relationship management skills including the ability to lead up and across the organization
- Proven ability to have, maintain, and establish strong contacts within the industry so as to be aware of current industry issues and practices.
Benefits
- Health insurance
- Retirement plans
- Flexible work arrangements
- Professional development opportunities
- Bonuses
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Risk Adjustment Project Coordinator I/II/III
Excellus BlueCross BlueShieldUPSTARS – продуктова IT-компанія, з якою злітають і люди, і бренди. Наш основний фокус – технологічні рішення та B2B-послуги для міжнародних клієнтів.
Job Description: Summary: The Risk Adjustment Project Coordinator supports the risk adjustment initiatives for Excellus Health Plan. Essential Primary Responsibilities/Accountabilities: Level I: - Review, monitor and track the medical record retrieval reports to identify provider issues such as but not limited to, refusals to comply with medical record requests. - Initiate outbound phone calls to noncompliant providers to resolve provider refusal and/or concerns related to the Health Plan’s request for medical records. - Builds and maintains strong working relationship with providers and office staff. - Educate providers of their contractual obligation to comply with Health Plan’s request in a professional manner to minimize provider abrasion. - Directly negotiates with providers to procure scheduled commitment to deliver requested medical records, retrieval method, and payable fees for the medical records. - Identify and escalate program related issues to the Project Manager and/or Manager as appropriate. - Identify patterns generated by external and internal action effecting provider adherence as it relates to medical record requests. - Communicates issues/findings to the Project Manager and appropriate team members. - Responsible for collecting and scanning project related documents and disbursing to the appropriate audience. - Analyze, compile, and prepare retrieved medical records for transfer. - Initiate Health Plan check requests for provider payments. - Collaborate with various stakeholders to resolve provider issues to relative to medical record retrieval activities. - Fosters an environment of continuous improvement and encourages innovative thinking. - Constantly exploring ways to increase efficiencies and productivity, reducing waste, and reducing costs. - Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. - Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. - Regular and reliable attendance is expected and required. - Performs other functions as assigned by management. Level II (in addition to Level I essential responsibilities/accountabilities): - Manage the respective risk adjustment failed quality assurance (QA) medical records reports through research and analysis to include but not limited to, review/verify medical record failed according to QA guidelines, triage 2nd level review of as needed, identify problematic trends, prepare summary of trends for review and discussion. - Monitors and reports on the progress of the resolution of high impact problems according to established standards. - Identify opportunities through trend analysis for improvement including but not limited to, non-compliant providers, medical recording targeting anomalies, vendor retrieval processes. - Serve as designated liaison between special handle provider that include, large provider groups and hospitals. - Initiate communication with special handle providers of upcoming medical record requests campaign. - Directly negotiate with special handle providers to procure schedule commitment, payments, etc. - Initiate requests for customized reports for special handle providers and deliver to the requestor. - Performs daily data import to the Provider Issue Tracking database, assign provider escalation work items to the Project Coordinators, etc. - Acts as a resource for team questions. - Monitors and executes reports on provider escalation open inventory. - Serve as the liaison and facilitator for member related requests and/or inquiries relative to the prospective risk adjustment programs. Will triage and track issues through resolution. Level III (in addition to Level II essential responsibilities/accountabilities): - Performs project management duties over small-tier risk adjustment or other initiatives as assigned. - Drives medical record retrieval activities in support of risk adjustment programs. - Works closely with Project Manager providing vendor oversight. - Assist Project Manager to determine project schedules, deliverables, assignments, tasks, project meetings (scheduling and meeting notes), status reporting, communication, and action items, as required. - Assist Project Managers and project teams to track work, tasks, and project assignments in order to keep projects on-time and within scope. - Serve as backup for Project Manager as needed. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels: - Associate degree in Business Administration or related field required. In lieu of degree, High School Diploma and three years related work experience required. - One year of related work experience required. - Demonstrates ability to operate within shifting priorities, demands and timelines. - Persuasive, encouraging, and motivating. - Strong all-around soft skills and high level of proficiency using written and oral communication skills - Demonstrated problem solving skills. - Strong organizational skills and ability to prioritize, multi-task, and work in a fast pace environment - Demonstrates technical proficiency in the following applications: MS Teams, Outlook, Word, OneNote and Excel. - Knowledge of claims, provider, and membership systems - Demonstrates ability to work effectively as a member of a team Level II (in addition to Level I minimum qualifications): - Four years related work experience is required. - A relevant bachelor’s degree is preferred. - Self-motivated; ability to take initiative and ownership. - Interfaces effectively with all levels of management. - Demonstrated analytical and business process development skills. - In-depth knowledge of Health Plan Operations and/or Risk Adjustment Operations. - Ability to maintain poise and composure under pressure and in difficult situations. Level III (in addition to Level II minimum qualifications): - Six years of related work experience is required. - Strong meeting facilitation skills - Ability to create, and manage project plans and schedule - Experience in drafting both internal and external communications to convey project findings and status. - Adept at conducting research when project-related issues occur - Expert knowledge of Health Plan Operations and/or Risk Adjustment Operations - Experience drafting concise and informative communication pieces at the department and/or project team level. Physical Requirements: - Works from a desk most of the time. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Level I: Grade N5: Minimum $20.02 - Maximum $33.03 Level II: Grade N6: Minimum $21.83 - Maximum $34.92 Level III: Grade N7: Minimum $23.56 - Maximum $37.70 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
IT Governance Manager
Freudenberg GroupThe Freudenberg Group is an equal opportunity employer that is committed to diversity and inclusion. Employment opportunities are available to all applicants and associates without regard to race, color, religion, creed, gender (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender identity or expression, national origin, ancestry, age, mental or physical disability, genetic information, marital status, familial status, sexual orientation, protected military or veteran status, or any other characteristic protected by applicable law.
• Establish, maintain, and continuously evolve IT governance frameworks, policies, and standards. • Implement and monitor adherence to IT rules, procedures, and regulatory requirements across all teams. • Provide expert guidance on IT process design and continuous improvement initiatives. • Define KPIs for governance effectiveness, track performance, and drive data-informed decision-making. • Design and deliver training programs on governance policies, compliance requirements, and best practices. • Lead preparation for internal and external audits, ensuring accurate documentation and timely follow-up on findings. • Act as a pro-active, trusted advisor to leadership teams, bridging communication between business, IT, and compliance functions.


