Assistant Manager- Ethical Governance Team

Niva Bupa; Gurugram District; On-site; INR 900,000 - 1,400,000; Full time

Job summary

Niva Bupa is seeking a Fraud Monitoring, Surveillance & Analytics professional in Gurugram to strengthen its fraud risk controls across insurance operations. The role focuses on detecting anomalies, applying sampling strategies, and developing risk monitoring frameworks.

The candidate will participate in inquiries, enforce committee decisions, and drive CAPA actions with cross-functional teams. A strong background in investigations and collaboration with risk committees is essential.

Qualifications

• Three years of relevant work experience in insurance/banking/financial industry.
• Analytical rigor with ability to build analytical dashboards.
• Deep knowledge of fraud investigation methodologies, evidence collection, and regulatory frameworks.

Responsibilities

• Surveillance execution to identify anomalies proactively.
• Implement sampling strategies to optimize data penetration and investigation accuracy.
• Develop fraud risk monitoring strategies and heat maps.
• Ensure adherence to defined turnaround times and company policies.
• Enforce actions per the Code and Ethics Committee, including asset recovery.
• Investigate and participate in high-value fraud cases as required.
• Close CAPA by coordinating with Management Risk Committee and executives.
• Coordinate risk assessments with business units to resolve data bottlenecks.
• Benchmark with industry peers to adopt best practices on fraud controls.
• Adhere to Fraud Risk Management Policy and SOPs.
• Provide refresher training and coaching on emerging fraud risks.

Skills

Fraud monitoring

Analytics

Investigation

Stakeholder management

Team collaboration

Job description

Role & responsibilities

1. Fraud Monitoring, Surveillance & Analytics
   • Surveillance Execution: Execute robust offsite monitoring, transaction surveillance, and red flag detection plans to identify anomalies proactively.
   • Sampling Strategy: Implement scientific, dynamic, and statistically significant sampling strategies to optimize data penetration and investigation accuracy.
   • Risk Mapping: Develop and deploy fraud risk monitoring strategies, including the creation of fraud risk ratings and process heat maps.
   • SLA Adherence: Detect, investigate, and prevent fraudulent activities within defined Turnaround Time (TAT) requirements and company policies.
2. Enforcement & Incident Management
   • Committee Enforcement: Enforce disciplinary and corrective actions recommended by the Code and Ethics Committee, including asset recovery, provider blacklisting, and filing First Information Reports (FIRs).
   • Investigation Participation: Act as a core participant in high-value or highly significant fraud investigations as required.
   • Root-Cause Resolution: Close the loop on investigation findings by executing corrective and preventive actions (CAPA) in coordination with the Management Risk Committee, business functions, and executive stakeholders.
3. Cross-Functional Collaboration & Industry Benchmarking
   • Risk Assessments: Partner with business units to ensure strict adherence to the fraud risk assessment plan, proactively resolving bottlenecks related to data extraction, analysis, and reporting.
   • Peer Benchmarking: Liaison with industry peers and competitors to gather updates, share insights, and adopt industry best practices on fraud controls.
   • Compliance & Conduct: Maintain absolute adherence to the Fraud Risk Management Policy, Standard Operating Procedures (SOPs), Customer Contact policies, and organizational disciplinary guidelines.
4. Knowledge Management Upskilling
   • Drive continuous improvement across teams by leading refresher training sessions, providing constructive feedback, and coaching colleagues on emerging fraud risks and mitigation techniques.

Preferred candidate profile

• Experience: Three years of relevant work experience in insurance/banking/financial industry
• Analytical Rigor: Proven ability to analyze complex financial/non-financial data and build analytical dashboards.
• Investigation Expertise: Deep knowledge of fraud investigation methodologies, evidence collection, and legal/regulatory frameworks.
• Collaboration: Strong stakeholder management skills to influence and align with legal, risk, and business committees
• Team Work: Should be a team player