Manager: Forensics Investigation

The Road Accident Fund’s mission is to provide timely and equitable assistance to those affected by motor vehicle accidents through the provision of appropriate social benefits to ensure financial relief and recovery for qualifying individuals.

Purpose:

The Manager: Forensics Investigation is responsible for conducting forensic investigations in the respective area into fraudulent matters such as claims lodged, medical fraud, corruption, bribery, collusion or cybercrime against the RAF. In addition, the incumbent will provide management advice on internal control weaknesses and improvements.

Key Performance Areas

Policy Review and Implementation

• Contribute to the development and implementation of departmental policy, methodology, anti-fraud and corruption strategy, fraud response plan, department operational plan and applicable standard operating procedures (SOPs).
• Keep up to date with effective policy and practice execution strategies.
• Ensure that all employees in the team know and understand the investigation legislative framework and RAF policies.
• Stay abreast on industry regulatory requirements and effect the applicable changes in the organization.
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Forensic investigation into fraud and related crimes.

• Assess a matter to determine whether there is possible fraud.
• Knowledge of RAF claims to be able to investigate fraud e.g. Medical and hospital expenses (past and future), Loss of income (past and future), Loss of support (past and future), Funeral  expenses, General damages.
• Identify possible related files or persons to be investigated.
• Allocate allegations for investigations in line with set guidelines and standards.
• Manage the planning and coordination of investigations as assigned by senior management.
• Manage the application of the approved investigation methodology during investigation/s.
• Manage and provide investigation capability into complex and noncomplex investigations on claims fraud, medical fraud, corruption, bribery, collusion, cybercrime, or misconduct.
• Manage investigations progress.
• Comply with relevant legislation and RAF policies.
• Quantify financial losses on the investigated case.
• Report control failures identified during the investigation to the relevant management.
• Manage the collation of documentary evidence.
• Manage case status changes in line with the antifraud policy or investigation methodology.
• Provide litigation support (testifying at disciplinary hearings, CCMA, court), and assist law enforcement agencies as and when they require help.
• Manage the maintenance of chain of custody.
• Manage reporting of criminal cases to the law enforcement agencies and keep proper records thereof.
• Manage monthly follow ups on progress update of criminal investigations.
• Manage monthly follow ups on cases referred/reported to regulatory bodies (LPC, HPCSA, Legal Ombud).
• Management monthly follow ups on court cases.

Project Investigations

Manage the administration, planning and execution of fraud investigation assignment.

• Approve resource needs: available budget, vehicles number of team members / time required.
• Conduct cost analysis.
• Planning and monitoring of team activities and investigation outputs during investigation assignment.

Administration

• Allocate investigation files.
• Conduct quarterly inspections.
• Monitor the team’s time sheets.
• Manage the maintenance of the case register/case management system.
• Manage (fleet management system) pool vehicle use and logbooks.
• Address all business unit audit findings and implement effective measures to manage the control environment in the FID and maintain clean audit in the region.

Reporting

• Provide monthly performance report against the operational plan.
• Provide investigation outcomes feedback to management in the region.
• Compile submissions and memorandums as and when required.
• Quality review investigation reports and adhere to the applicable standards and guidelines.
• Develop functional reporting systems, for management, projects or performance reporting.
• Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.

Stakeholder Management

• Build and maintain strategic partnership with business unit managers in the respective areas.
• Provide technical and administrative management to the forensic investigation team in the respective areas.
• Engage and communicate the FID mandate to internal and external stakeholders to ensure that they understand the responsibility of the FID unit.
• Recommend corrective actions to senior managers to improve their processes and controls to prevent similar incident of fraud from reoccuring in the future.
• Communicate with all levels of stakeholder contact.
• Represent the Fund in relevant external activities and events.

People management

• Ensure the sourcing, development and retention of a high-performance team.
• Manage the recruitment of the operational workforce in line with employment equity targets.
• Manage staff in the department to ensure that they achieve their objectives in line with the strategic objectives of the RAF.
• Manage the implementation of people management processes and procedures to control/regulate workplace conflict and/orinstitute corrective measures and consultation processes to address deviations from standards.
• Allocate, direct, motivate and evaluate subordinates to help them achieve their individual goals.

Qualifications

• Bachelors Degree/Advanced Diploma in Commerce (Bcom Accounting, Internal Audit, Financial Mangement, Risk Management, BCom Law, Forensic Accounting, Economics and Information Systems), Forensic Science or LLB.
• Postgraduate related qualification in Accounting, Auditing, Financial Management, Risk Management, Law, Information Technology/ Information systems, Forensics, BCompt Honours will be an added advantage.
• Certified Fraud Examiner (CFE) or Forensic Practitioner (ICFP) will be an added advantage.

Experience

• Relevant 6 -8 years’ experience in forensic investigation into white-collar crime (such as but not limited to healthcare or insurance claim fraud, corruption, bribery, forgery and counterfeit, identity theft) of which 2 years must have been on a management/supervisory level.

Behavioural

• • Resilience
  • Communication
  • Working with People
  • Network and Alliances
  • Planning, Organising and Coordinating
  • Employee Engagement
  • Personal Mastery
  • Judgement and Decision Making
  • Ethics and Values
  • Client Service Orientation

Managerial

• • Change management
  • Coaching and mentoring
  • Conflict management
  • Critical and innovative thinking
  • Direction setting
  • Facilitation and Presentation Skills
  • People management
  • Policy conceptualisation and formulation
  • Risk Management
  • Programme/project management
  • Service Delivery Innovation
  • Stakeholder development and relations
  • Reporting

Technical

• • Demonstrable understanding of the Criminal Procedure Act and law of evidence
  • Demonstrable experience of working with law enforcement agencies.
  • Demonstrable experience of litigation support (Testifying at disciplinary hearings, CCMA and court).
  • Investigation management skills
  • Problem analysis and judgment
  • Computer literacy
  • Statistical analysis
  • Demonstrable ability to plan, execute and control case management.

Road Accident Fund Values

• Integrity
• Compassion
• Accountability
• Respect
• Excellence

The Road Accident Fund subscribes to the principles of employment equity and preference will be given to People with Disabilities.

Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful.

Security Vetting shall be conducted on all prospective employees.

It is the applicants’ responsibility to have foreign qualification evaluated by the South African Qualification Authority (SAQA) and to provide proof of such evaluation.