Loss Recovery Service

4 months ago

Newcastle upon Tyne, United Kingdom NHS Business Services Authority Full time

**In this role, you are accountable for**: To work with members of the Health Exemption Services carrying out appropriate fraud awareness work. To investigate, within operational and legislative guidelines to the highest standards, patient fraud allegations identified within Health Exemption Services. Ensure that appropriate civil and/or criminal remedies are applied by the following means: Analyse possible avenues and methods of investigation to obtain evidence through various relevant means. Convert technical information into plain English, suitable for presentation at Court.

Construct prosecution files and submit to Crown Prosecution for their consideration. Maintain investigation files and evidence with due regard to the Criminal Procedures Investigation Act 1996, including management and disclosure of unused material in accordance with the act. Manage and prioritise own caseload, adhering to non-negotiable deadlines imposed by courts and police. Attend criminal and civil courts, in the capacity of witness and/or case officer to give evidence competently, including in cross examination.

Provide guidance, advice and instructions to Counsel and other legal professionals before and during criminal and civil proceedings. Undertake duties with due regard to patient care and safety, particularly in terms of clinical circumstance, sensitivity and confidentiality, in accordance with Data Protection legislation and the NHS Confidentiality Code of Practice. Carry out the responsibilities of the post with full and due regard to NHSBSA policies and procedures and negotiated agreements including those on Equal Opportunities and Health and Safety. Maintain an up to date working knowledge of all relevant and appropriate legislation, standards and procedures, including NHS structure, policy, detection and investigative methods.

Maintain a good knowledge of available Information Technology and how it can best be used in the detection and investigation of fraud and to present data in a clear and appropriate format, often reflecting specific requirements. Review processes and procedures within Health Exemption Services identifying system weaknesses where fraud and error could occur and make recommendations to reduce and/or eradicate the risk. Undertake fraud and error measurement exercises in relation to the work of Health Exemption Services. Prepare and present reports, submissions and other documents as required.

Provide clear, complete and accurate information for the purpose of internal and external senior management and professionals. Ability to manage and analyse large amounts of data, draw sound conclusions and present findings in an easily understood format to direct the Health Exemption Services on proactive initiatives. Promote and contribute to the development of policies, practices and procedures within Health Exemption Services. Work outside normal office hours when required, which will occasionally necessitate extended hours and possibly weekends.

Frequent travel and overnight absence from home when required. Appropriate use, maintenance and security of NHSBSA premises, assets, evidence, exhibits and equipment. Ensure the integrity and continuity of evidence at all times. Responsible for personal development.

Undertake relevant training as identified by line management. Provide continuous support, advice and guidance, and manage the expectations of, witnesses and victims related to suspected patient fraud investigations, from the time of initial contact until after the conclusion of an investigation including any court process. To work in circumstances where there is potential to encounter hostile situations. Do you hold a clean, Full UK Driving License.

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