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* Work as a qualified Local Counter Fraud Specialist (training will be provided) to conduct fraud investigations in line with Criminal Procedure and Investigations Act 1996 and Police and Criminal Evidence Act 1984 including interviewing of witnesses and suspects and preparation of case files.
* Managerially reporting to the Head of Local Counter Fraud Service, the post holder will advise and liaise with the Head of Local Counter Fraud Service and Senior Managers on appropriate sanctions and civil recovery measures. You will work as a member of the Counter Fraud Team at the direction of the Head of Local Counter Fraud Service and deputise for the Head of Local Counter Fraud Service as and when required.
Job Overview
The post holder will:
* Work as a qualified Local Counter Fraud Specialist (training will be provided) to conduct fraud investigations in line with Criminal Procedure and Investigations Act 1996 and Police and Criminal Evidence Act 1984 including interviewing of witnesses and suspects and preparation of case files.
* Managerially reporting to the Head of Local Counter Fraud Service, the post holder will advise and liaise with the Head of Local Counter Fraud Service and Senior Managers on appropriate sanctions and civil recovery measures. You will work as a member of the Counter Fraud Team at the direction of the Head of Local Counter Fraud Service and deputise for the Head of Local Counter Fraud Service as and when required.
You will be responsible for preparing case files and Counter Fraud reports for both criminal and civil courts and present those reports or files as required. You will liaise with Internal Agencies including Internal Auditors; Human Resources; Payroll Departments and Departmental Heads. The role will also require engagement and liaison with external agencies.
Main duties of the job
* Work within the Counter Fraud Service on the delivery of an integrated, comprehensive and professional Counter Fraud Service provision to the Health Board.
* Be responsible for Counter Fraud arrangements in a number of arenas, including the creation of an anti-fraud culture, deterrence, prevention, detection, and investigation of fraud and corruption.
* Support the development of an Annual Work Plan and provide advice and guidance to the Head of Local Counter Fraud.
* Deliver a professional Counter Fraud service provision to the designated Health Board and apply the Counter Fraud standards and guidelines as laid down in the NHS Counter Fraud and Corruption Manual.
* Maintain good working relationship with Internal Audit, External Audit, NHS Counter Fraud Authority, NHS Wales Counter Fraud Services and other agencies in the delivery of the Counter Fraud Service provision.
* Protect the confidentiality of sensitive/personal/patient related information by operating at all times in compliance with the Data Protection Act 1998 and Human Rights Act 1998.
The ability to speak Welsh is desirable for this post; Welsh and/or English speakers are equally welcome to apply.
Working for our organisation
If you relish a challenge, have a passion to help others or simply fancy a fresh start, then Betsi Cadwaladr University Health Board (BCUHB) North Wales, has all the right ingredients. The largest health organisation in Wales, providing a full range of primary, community, mental health, acute and elective hospital services for a population of around 700,000, across North Wales. Join our team and get the support you need, in line with our Organisational Values and ‘Proud to Lead’ competence framework.
Enjoy being part of working with engaged leadership at all levels, and be assured we are committed to promoting equality and diversity, and are proud to welcome applicants under the “Disability Confident Employer” scheme.
Please check your email account regularly. Successful applicants will receive all recruitment related correspondence via the email account registered on the application form.
Applications may be submitted in Welsh. Applications submitted in Welsh will not be treated less favourably than an application submitted in English.
Detailed Job Description And Main Responsibilities
WORKING RELATIONSHIPS
The key working relationships are as follows:
Director of Finance, Finance Staff, Senior Managers, Departmental Managers, Internal Audit, People & Organisational Development, Trade Unions, Other NHS organisations, Local Authorities & other partners, External Audit, NHS Counter Fraud Authority, NHS Wales Counter Fraud Service.
GENERAL
The post holder will:
* Manage the investigation of fraud cases for the Health Body for whom the post holder is the nominated Counter Fraud Specialist.
* Produce investigation plans working with all relevant parties to ensure that the investigation is carried out in compliance with legal requirements and with due diligence. Plan the course of an investigation in conjunction with the relevant Managers and evaluate the appropriateness of arrests, the application for search warrants and their execution, the granting of bail and charging of alleged offenders with offences.
* Produce case papers and reports in conjunction with the operational requirements of conducting criminal investigations, which often requires working to the tight deadlines inherent in the Criminal Justice System.
* Complete fraud investigations in accordance with current legislation and NHS Counter Fraud Authority guidelines.
* Conduct formal interviews with witnesses both internal and external to the NHS in accordance with the Police and Criminal Evidence Act 1984 and conduct interviews under caution with alleged offenders, on both a voluntary basis and when the alleged offender is under arrest, in accordance with the same act.
* Prepare criminal cases for prosecution at both Magistrates and Crown Court and resume the responsibility of officer in charge.
* Communicate with Solicitors and officers of the Court in pursuance of issues in conflict between the Health Body and other parties.
* Act as witness at Magistrates Court, Crown Court, Civil Court and disciplinary hearings and support witnesses where required.
* Complete the role and responsibilities of case disclosure officer in accordance with the Criminal Procedure and Investigations Act 1996 rules on disclosure and the Attorney Generals guidelines.
* Where fraud is proven the post holder, in conjunction with the Head of Local Counter Fraud Service, will be responsible for seeking the application of a combination of appropriate sanctions. These may include criminal proceedings and/or the referral of cases for Disciplinary Hearings.
* Be responsible for seeking recovery of monies lost on behalf of the Health Body through the Criminal or Civil Courts.
* Promote awareness of the –Betsi Cadwaladr University Health Board Counter Fraud, Bribery and Corruption policy.
* Utilise appropriate experts to assist in the identification of potential local risk areas and to take action on information supplied by NHS staff or members of the public.
* Identify potential fraud through the utilisation of intelligence and to develop the use of information resources to collate data.
* Utilise IT to identify and combat fraud and utilise it in data analysis, data entry and the storage of data to create and format databases and spreadsheets in the furtherance of fraud investigation.
* Report to senior management, auditors or contractors on the completion of fraud work (proactive or reactive) including highlighting system weaknesses and recommending improvements.
* Undertake regular Awareness presentations across the Health Board to a variety of staff groups and audiences.
COMMUNICATION AND RELATIONSHIPS
* To provide sensitive information requiring negotiating, persuasive skills. To discuss Counter Fraud queries with stakeholders..
* To discuss counter fraud issues with stakeholders which may be contentious; provides advice on Counter Fraud and corporate issues to stakeholders, negotiating with NHS / external organisations in relation to NHS Service issues which may affect costs and amounts of money which required to be recovered due to NHS fraud which has occurred.
* To advise stakeholders and potential witnesses, encouraging the correct course of action, developing and delivering fraud awareness presentations to various staff groups.
* To attend Disciplinary Hearings and act as witnesses where necessary.
* Regularly meet with the Assistant Director of Finance to agree work plans, review performance and provide briefings in relation to active cases.
KNOWLEDGE, TRAINING AND EXPERIENCE
* To use specialist Counter Fraud knowledge across work procedures and practices, which are underpinned by theoretical knowledge and practical experience.
* To use specialist knowledge across all NHS sectors, providing specialised advice the senior managers within the Health Board on matters relating to Counter Fraud issues, providing detailed advice and guidance, which has been acquired via Professional Qualifications and experience.
JUDGEMENT AND ANALYTICAL SKILLS
* To exercise judgments involving facts or situations, which require the analysis, interpretation and comparison of a range of options. This will be in conjunction with the Head of Local Counter Fraud Service.
* To analyse trends involving, using a wide range of data and assumptions which may indicate that NHS fraud has occurred.
* To develop and advise on complex issues relating to NHS fraud matters and investigate and resolve complex issues relating to Counter Fraud.
* When interrogating and analysing information systems to identify NHS fraud issues; to report thereafter to the Head of Local Counter Fraud Service.
* Exercise knowledge across a range of managerial work procedures and practices underpinned by theoretical knowledge and practical experience.
* To create reports from internal and external sources that allow evaluation of the Health Board’s counter fraud service.
* Assess, interpret and apply national guidance, legislation and local policy in order to ensure counter fraud strategies are compliant.
PLANNING AND ORGANISATION
* Plans and manages the caseload assigned to the post holder.
* Promptly investigate potential frauds under Police and Criminal Evidence Act -1984.
* To plan and prioritise own work.
POLICY AND SERVICE DEVELOPMENT
* To support the Head of Counter Fraud Service in the development of Counter Fraud, Bribery and Corruption policy of the Health Board.
* To implement the Health Boards Counter Fraud, Bribery and Corruption policy and to propose policy and service changes across all sectors of the NHS in North Wales.
* To propose changes and redesign of service in order to fraud proof the Health Boards systems and processes, which may impact on all sectors of the service which are managed by the Health Board.
FREEDOM TO ACT
* Responsible for the day-to-day operational management of own workload, in line with the workplan as agreed by the Head of Counter Fraud Services.
* The post holder will be expected to work independently guided by the Head of Counter Fraud Services and with broad occupational policies, but has to interpret these and is guided by Welsh Government and national counter fraud strategies.
* The post holder will need to assimilate and summarise complex documents, compare facts and analyse situational data from a range of sources, develop options and assess risks and opportunities to the organisation.
* To work to achieve agreed objectives and given freedom to do this in their own way of working, within broad professional policies; acts and provides advice under the guidance of the manager.
RECORDS MANAGEMENT
* The post holder has the responsibility for timely and accurate record keeping and where appropriate in accordance with professional guidelines.
* The post holder has the responsibility for the creation and maintenance of records in accordance with Health Board policy and the Data Protection Act.
Person specification
Driving
Essential Criteria
* This post requires a full driving license and use of vehicle.
Criteria
Essential Criteria
* Postgraduate Diploma Level or equivalent experience.
* Knowledge of relevant current law and the criminal/civil process.
* Good working knowledge of database and spreadsheet IT packages including Word & Excel).
* Accreditation as Local Counter Fraud Specialist or to be willing to work towards
* Experience in the arena of criminal / internal including disciplinary investigations.
* Knowledge of: - Procedures applicable to the successful management of criminal, civil investigations and disciplinary investigations, a proven track record in this area. - U.K. law as it relates to corruption, bribery and fraudulent activity - Preparation of case files for submission to solicitors and barristers. - Continual professional development.
* Experience of dealing with highly complex and politically sensitive issues within a large organisation
* Experience of completion of the Criminal Justice System MG forms.
* Able to present relevant information in a concise and persuasive format
* Excellent interpersonal skills demonstrating credibility, influence and political acumen; building and maintaining effective relationships across all grades and disciplines and within a wide variety of circumstances
* The ability to work as part of multi-disciplinary teams at operational level, both within and outside the Health Board.
* The ability to work on your own initiative, organising your own workload
* Ability to achieve targets and objectives within a demanding and pressured environment against challenging deadlines.
* Knowledge of legislation and procedures applicable to the successful management of criminal, civil and disciplinary investigations.
* Sound judgment, decision making, and organisational skills
* Able to interpret legislation, national guidance as appropriate to the role.
* Self-motivated and committed to developing self and team members
* Ability to use Spreadsheets (Excel), Word-processing (Microsoft Word), Databases and E-mail to a good level.
* Highly developed organisational skills.
* Excellent numeracy and analytical skills.
* Highly developed verbal and communication skills with ability to relate to people at all levels.
* Excellent report writing skills with an ability to distil information into key summaries.
* Accurate record keeping skills.
* Project management skills.
* Enthusiastic, committed, proactive and innovative.
* Politically astute and high level of intuition.
* Appetite for hard work and challenges.
* Show resilience, stamina and reliability under sustained pressure, never losing sight of objectives.
* High level of personal integrity.
Desirable criteria
* Specialist knowledge of NHS legislation and NHS finance policies.
* Knowledge and experience in a NHS finance environment.
* Data Analytics training or experience of the delivery of Data Analytics outcomes.
* Evidence of further specialist training and experience.
* A working knowledge of fraud investigation techniques and Health Service payment systems.
* A knowledge of public sector financial systems.
* NHS / public sector experience.
* Welsh Language Skills are desirable levels 1 to 5 in understanding, speaking, reading, and writing in Welsh
Seniority level
* Seniority level
Entry level
Employment type
* Employment type
Full-time
Job function
* Job function
Finance and Sales
* Industries
Hospitals and Health Care
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