1 / 48

Using a Business Operations Management Approach to Control, Analyze, and Improve Your Information

Using a Business Operations Management Approach to Control, Analyze, and Improve Your Information. John Gatto, CISA, CRISC, Divisional VP Audit Services at HCSC. Bobby Koritala, Sr VP of Operations at Infogix, Inc. John Gatto, CISA, CRISC,. Divisional Vice President. Audit Services - HCSC.

emma
Download Presentation

Using a Business Operations Management Approach to Control, Analyze, and Improve Your Information

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Using a Business Operations Management Approach to Control, Analyze, and Improve Your Information John Gatto, CISA, CRISC, Divisional VP Audit Services at HCSC Bobby Koritala, Sr VP of Operations at Infogix, Inc.

  2. John Gatto, CISA, CRISC, Divisional Vice President Audit Services - HCSC John Gatto has been with Health Care Service Corporation (HCSC) in Chicago, IL since December, 2005. He is responsible for all aspects of IT Audit for the four Plans comprising HCSC (Illinois, Texas, New Mexico and Oklahoma) and encompasses NAIC / MAR compliance and testing, risk based audits, advisory engagements for new development projects, coordination of SSAE #16 reviews and E&Y Year-End Financial Audits. John is a member of a number of Steering Committees within the IT area of HCSC.

  3. Bobby Koritala Sr Vice President of Operations Infogix, Inc. Bobby Koritala joined Infogix in 2009 and leads the Marketing and Product Development Group. Prior to this, Bobby served as the Director of Risk Technology Solutions at Protiviti, Vice-President of Investments at Open Prairie Ventures, Director of Applied Technology at Blue Cross Blue Shield, Director of Product Development at Lexis Nexis, and Senior Manager, Software Development at SPSS. Bobby has a Bachelor of Arts degree in computer science and physics from Coe College, a Master of Science degree from the University of Wisconsin, and an MBA from Kellogg School of Management.

  4. 4 We Impact Millions of People. Every Day. • Health insurance claims • Property insurance billing • Utility billing • Bank statements • Gift cards • Mortgages • Purchases at stores • Credit card transactions

  5. 5 Why Do We Exist? To provide solutions that transform the operations of our customers….thus allowing them to focus on what is most important…….their customers.

  6. 6 Our Business Operations Management Suite • Key Performance and Risk Indicators • Real-Time Process Performance • Operational Intelligence • Operational Reporting • Analytics • Balancing • Reconciliation • Exception Management

  7. 7 Who We Help Executives/ Leadership Directors/ Managers Insight Analysts/ Developers Control

  8. 8 Functional Areas We Serve • Operations • Finance • IT

  9. 9 Environmental Challenges in Core Processes • Lack of real-time operational reporting • Lack of visibility into your process level information • Disparate systems and platforms • Product centric information silos • Multiple manual steps and semi-automated controls

  10. 10 Our Solutions at Work Governance Processes Management Processes

  11. Presentation Objectives 8/25/2014

  12. Presentation Objectives 8/25/2014

  13. HCSCEnvironment • Very complex infrastructure • Very complex applications • Mainframe and distributed • Batch • On-line / real time • Thousands of interface files • ACA expanding that problem 8/25/2014

  14. Relationship 8/25/2014

  15. Infogix Solutions Timeline Implemented ACR Summary Implemented Insight on 13 Interfaces Started ACR 4.2 Upgrade 2011 2010 1982 1993 2009 Implemented ACR Detail on MVS Added Insight to all 1,856 ACR Controls Developed Data Integrity Policy 8/25/2014

  16. Many problems arising • New Solutions Needed 8/25/2014

  17. Presentation Objectives 8/25/2014

  18. NAIC MAR and IT Audit 8/25/2014

  19. What is NAIC MAR? 8/25/2014

  20. HCSC Audit Plan 8/25/2014

  21. NAIC MAR Interfaces 8/25/2014

  22. MAR Interface Data transmission or feed into a financially significant application, job, or process. 8/25/2014

  23. Interface Metrics 8/25/2014

  24. 2012 MAR Overview ITG GC’s Non-ITG GC’s Application Interfaces • Actuary • Dearborn National • Hallmark • Provider Services • IAM (68 applications) • Reliance for E&Y • SOC-1 – 25 • Financial -19 • Non-reliance - 24 • Risk Management • Strategic Planning • Physical Security • Incident Management • Change Management • Release Management • IT Operations • AS/400 • SDM • 50 unique targetsystems • 110 interfaces • balancing • duplicate file • missing file • 5 reports for adminpurposes 8/25/2014

  25. Interface Audits - Back in The Day… John Gatto, 2006 8/25/2014

  26. Real Ugly

  27. Real Ugly 8/25/2014

  28. Interface Audit Challenges 8/25/2014

  29. Presentation Objectives 8/25/2014

  30. Use of Insight

  31. Using Insight ITG Corporate Governance IT Audit 8/25/2014

  32. NAIC MAR Project and Insight • Identified Deficiencies by Internal and External Audit • Implemented 3 Types of Controls • Missing File Check • Duplicate File Check • Balancing • Developed coordinated process with Corporate Governance, Internal Controls Evaluation, Internal Audit and ITG Controls group. • Needed ease of monitoring and testing 8/25/2014

  33. Benefits of Insight 8/25/2014

  34. View of Controls labeled by Source to Target System A red gauge indicates an error. The green gauge indicates no errors. An empty gauge indicates that the controls haven’t processed yet for the time frame specified within the filter. 8/25/2014

  35. Subview: Balancing, Duplicate Check and Missing File Checks 8/25/2014

  36. Execution Results: Job Name, Execution Date, Time and Return Code 8/25/2014

  37. Drill Down to Return Code and Error Message 8/25/2014

  38. ACR Reports – Detailed Information 8/25/2014

  39. Resolution Notes 8/25/2014

  40. Looking Ahead 8/25/2014

  41. 8/25/2014

  42. Implement ACR Unix Controls Insight Upgrade 6.3: Send Non ACR Controls to Insight Insight Upgrade 6.3: Link to Help Desk Continued Development of ACR and Insight Controls Looking Ahead 8/25/2014

  43. 43 Typical Areas of Application • Claims • Data Warehouse • Actuarial Reserves • Billing • Statements • Payments • Commissions • Provider Services • Member Services • General Ledger • Financial Reporting • Compliance • SOX • NAIC MAR • Audit • Enrollment

  44. 44 How We are Different • Provide real-time end-to-end process level performance measurement and visibility • Real-time operational insight into errors and process inefficiencies caused by disparate systems and product silos • Automate reporting, reconciliations, and controls across your critical business processes

  45. 45 Putting it all Together Infogix Business Operations Management Solution

  46. 46 Sampling of Our Customers

  47. 47 About Infogix • Based in Chicago area • Many customer relationships > 20 years • Customers include: • 20 of the Fortune 100 • 7/10 of top Commercial Banks • 6/10 of top P & C Insurers • 3/10 of top Health Insurers

  48. 48 Questions?

More Related