Overarching risks
Risk Catagories
Financial
Pension plan solvency
Genworth stability
Failure to monitor and manage financial investments and obligations could result in negative performance of the company.
These risks pose possible financial impacts to our business, but are not specifically tied to core business operations.
Human capital
Wage inflation, recruitment, retention
Leadership succession planning
High/Low performer turnover rates
Workforce and Business Operations - Post Pandemic
Failure to appropriately manage all aspects of our employees and resources we will see impacts in retention, development and acquisition of our workforce.
These risks are association with our employees, their performance, compensation, recruitment, retention, etc.
External mandates or legal
Provider antitrust lawsuit
Regulatory Direction - Impacts of Subsidies
Regulatory Direction - Preauth Limitations
BlueCard Modernization
Regulatory changes - TCR/CAA Implemenation
Failure to implement changes in our business that are driven by external requirements will result in regulatory, legal or licensing penalties.
These risks are related to external forces that we may have little to no influence over, but must react to.
Operational defense
Buisiness Continuity - Availability of Our Services
Third Party Risk - Privacy / Security
Third Party Risk - Key Partner Seclection, Performance, and Viability
Cybersecurity / Privacy
Without appropriate focus on operational defensive practices we will see business impacting events that cause financial, membership or reputational harm.
These risks are tied to defensive operational practices that we perform to protect business operation.
Operational performance
Loss of key group(s)
Sapphire Edge/Medicare Advantage
Reimbursement accuracy
System stabilization - HealthRules operations
Provider Experience
Without improving operational performance of the services we provide we will see negative financial, membership and reputational impacts.
These risks are tied to operational performance of the services we provide.
Strategic initiatives
Currently identified risks
Internal Technology Evolution - System Modernization
2023 ACA Re-Entry
Failure to effectively deliver on strategic initiatives will cause financial, operational and reputational harm.
These risks are tied to strategic initiatives within the organization.
Inspect & Adapt - revised model
Utilize this model to improve enterprise level visibility and reporting
Align these overarching risks with a clarified risk universe
Define a set of overarching risks that allow us to categorize our risk pool
Problem being solved (why?)
While their is agreement they are all critical risks, it revealed the need to refine our risk organization and presentation model.
The current ERM top tier risks vary from high level long term strategic initiatives to short term tactical issues needing addressed.
