How We Protect Our Business, Members Through Risk Management
July 31, 2024
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Louis McElveen has had three big chapters to his professional career. First as a certified public accountant mostly working with tax preparation. Then he transitioned to working at BlueCross BlueShield of South Carolina in Corporate Finance.
That change was 18 years ago. But for the past five years, in his third chapter, McElveen serves as the Chief Compliance and Risk Officer with BlueCross, including overseeing the Corporate Audit division of the company.
“It’s much more than just Corporate Audit, but that is a big part of what we do,” he says. “Overall, our job is to ensure there are processes and procedures in place to manage the various risks of our company.”
BlueCross has served South Carolinians for more than 75 years. The work of McElveen’s office is a big reason the business is stable and consistent. His team reviews areas across the company, everything from hiring and compensation to security and building access.
“What's the risk that somebody could hack into the computer system or the risk that somebody could have access to the system after they quit? What's the risk that we're not billing customers the right way? Those are just a few of the risks our team addresses,” he says.
McElveen and his team protect the company from a number of risks every year. Our Enterprise Risk Program is designed to first understand what our potential risks are and then manage those risks. To do that, we need to stay open and connected to all employees and management.
For example, each year they interview several members of management across the company to learn what is going on and what new risks may be on the horizon.
“Virtually everything we do is to help keep this company operating smoothly and take care of our members. If we can do those two things as a company, then good things happen,” he says.“ When you think about it, many times when companies have failed, they were either not paying attention to their external risks or they imploded internally, and the audit/risk management function wasn't working correctly. If you don't manage risk properly, the company will not stand the test of time. And we are a big part of managing that risk,” he says.
Maintaining objectivity and independence is key to this work. McElveen reports directly to the BlueCross Board of Directors, which gives his team the ability to look at things outside the normal chain of command.
All of this isn’t just important for the business or its employees. Ultimately, BlueCross serves its members, South Carolinians who rely on it for their health care insurance.
“Our primary responsibility is to our members who trust us to help them manage their health care needs,” he says.
It may sound like a big job, but the team helps by conducting interviews with leaders across the company every year. They get an inside look at how BlueCross leaders work. And McElveen loves that part.
“One thing I love about it is it is completely different than anything I've done. When I was a CPA doing tax work and when I was in Corporate Finance, it was mostly about numbers. I had a calculator on my desk all the time,” he says. “When I joined Corporate Audit five years ago, there were no more numbers. It's about controls and processes. And because we are looking at the whole company, I meet more people. I'm learning more about how the business is run. It's really been an eye-opening experience and really rewarding to get to know people and understand how the business is run.”
Corporate Audit is just one small part of McElveen’s job, but the themes are the same whether he is focused on audit or health care fraud — protecting the company and its members.
“Other parts of the company are the offense. We're defense. We're trying to protect what we've got. I'm not trying to grow the business. I'm trying to make sure what we've got doesn't get taken away or abused,” he says.