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Claims Investigation Officer

3 months ago

Mountain Ash, United Kingdom Cwm Taf Morgannwg University Health Board Full time

Job summary

The postholder will be responsible for managing their cases and support the Legal services manger in the provision and planning of safe high quality health care to patients across all areas of Cwm Taf Morgannwg University Health Board, inclusive of the independent contractor services - in particular, the case management of Claims, Inquests and Redress aspect of Concerns and to contribute to safety of staff and visitors via the effective management of Claims, Redress & Inquests.

Main duties of the job

The primary responsibility of the post holder is to support the Team Manager - Claims in the planning and execution of effective systems and processes for managing Clinical Negligence, Personal Injury Claims, Inquests, and Redress matters under the Putting Things Right regulations. This involves ensuring compliance with Health Board policies and the Civil Procedure Rules to minimise financial impact and reduce clinical and financial risks.

The post holder will manage their own caseload, often handling complex claims, conducting thorough investigations on Redress matters, and managing inquests from start to finish.

In addition, the post holder will deputise for the Claims Manager when necessary, identifying and addressing related organisational risks. They will allocate work to junior team members, provide expert legal advice on medico-legal issues, and ensure lessons learned from claims and Redress are communicated and acted upon by senior staff.

The post requires a high level of organisation, the ability to prioritize autonomously, and a responsive approach in line with national guidelines, legislation, and professional requirements.

The ability to speak Welsh is desirable for this post; English and/or Welsh speakers are equally welcome to apply.

About us

Cwm Taf Morgannwg University Health Board is part of the NHS Wales family. Our Health Board provides primary, secondary and community health and wellbeing services to around 450,000 people living in three County Boroughs: Bridgend Merthyr Tydfil, and Rhondda Cynon Taf.

We live by our core values:

We listen, learn and improve We treat everyone with respect We all work together as one team

We are a proud local employer; around 80% of our 15000 workforce live within our region, making our staff not only our lifeblood of our organisation but of the diverse communities that we serve.

Job description

Job responsibilities

You will be able to find a full Job description and Person Specification attached within the supporting documents or please click Apply now to view in Trac.

Person Specification

Qualifications

Essential

Educated to degree level or equivalent in law (CILEX Qualifications), or equivalent claims management, redress and inquest experience. Relevant experience in law or related subject. Good knowledge of risk assessment tools and methodologies and Clinical Governance in general. Clear understanding of responsibilities relating to relevant aspects of the Data Protection Act and Freedom of Information Act. Clear understanding of the concept of evidence based practice and clinical effectiveness.

Desirable

Understanding of the Health Service. Knowledge and experience of the administration and use of the Datix system. Knowledge of Duty of Candour and the Putting Things Right Regulations. Root Cause Analysis Investigative processes.

Experience

Essential

Case management experience Experience of working in Clinical Negligence/Personal Injury/Redress/Inquest. Experience of working in a busy environment, working to tight timescales and deadlines.

Desirable

Experience of working in Health Service. Delivery of educational and training programmes to all levels of staff.