Governance, Risk and Compliance for Insurance Industry

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The MetricStream solution for Governance, Risk and Compliance (GRC) plays a key role in enabling health insurers to achieve these objectives through a unified and adaptable system bringing a clear and unambiguous approach to GRC processes through automated workflows and centralized information management. With MetricStream, you can document, track and manage GRC initiatives at all organizational levels for business functions as well as IT processes fulfilling insurance regulatory compliance requirements and implementing effective risk strategy with a reliable control systems and internal auditing activities.

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Policy and Procedure Management: The solution enables companies to adopt an electronic and automated approach to managing policies and procedures across the enterprise. This web based solution provides a central repository to store, organize and implement all organizational policies facilitating accountability and foster communication.

Risk Management: The solution has a comprehensive framework for managing risk that provides top-down view of organizational objectives, identifies significant risks to meeting those objectives, and captures risk mitigation plans and ownership toward a variety of risk scenarios ranging from strategic and enterprise risks (ERM) to a growing range of operational risks in the insurance industry.

Internal Audit Management: The internal audit solution for health insurance companies is a comprehensive application to help companies manage a wide range of audit-related activities, data and processes and support all types of audits, including internal audits, financial audits, compliance audits, operational audits, IT audits, HIPAA security audits, vendor audits and quality audits. The solution allows risk-based auditing and maintains audit universe, schedules, programs, documentation, work papers, findings and audit reports.

Training Management: MetricStream provides powerful capabilities for enabling training and awareness of policies and procedures in health insurance companies by bringing together a comprehensive content repository and a framework for simplified training delivery and tracking. The health insurance compliance training management solution ensures that the training requirements are fully met and recorded from a compliance policy standpoint as well as provides employees easy access to a variety of training programs that map to various guidance documents, policies, procedures, regulations and standards such as HIPAA and ERISA.

Remediation and Corrective Action Plans: The GRC solution for Health Insurance companies provides complete remediation and corrective action management capabilities with real-time visibility into the issue and exception data with analytics for trend analysis and status tracking. Investigation and root-cause analysis is driven by collaborative workflows and the solution provides functionality to manage the corrective action plan life cycle, which includes initiation, work breakdown, due dates, completion dates, updates, evaluation, closure, monitoring, and reporting.

IT GRC: MetricStream provides a comprehensive IT GRC solution for IT audit, compliance and risk management for insurance industry. Designed to support insurance industry standard frameworks – like COBIT - the solution ensures sustained compliance of IT controls, effective IT risk management and streamlines IT auditing delivering a single system of record for IT GRC.

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