Fraud Prevention Manager

**THE JOB AT A GLANCE** To proactively prevent and detect suspicious and fraudulent activities in the channels, preferably at deal stage, before claims are submitted, identify fraud trends, and partner with the group investigations teams on reported claims. This role would also continuously develop process improvements within the RML distributions channels, particularly funeral, and report on these trends to management. The role will work closely with multiple departments, including to develop and implement robust fraud prevention strategies within RML. The role requires a keen eye for identifying patterns, strong analytical skills, and the ability to communicate fraud risks effectively both internally as well as to senior external stakeholders. The incumbment must also have industry experience and contacts that will assist them to stay abreast of fraud "trends" including syndicates, to enable RML and our policyholders to avoid falling victim to fraudulent schemes. **WHAT WILL YOU DO?** Fraud Risk Identification and Assessment: - Conduct risk assessments to identify potential fraud risks within the RML space - Collect and analyse data to detect fraudulent activities and identify trends or irregularities within the industries and channels that RML operate, predominantly in the funeral space. - Collaborate across various teams to assess fraud risks in business processes and recommend corrective actions. - Contribute to the Due Diligence process before new funeral parlors or other partners are onboarded. - Ensure that expenditure is incurred within the limits of the sanctioned budget. - Ensure that new risks are identified, reported to risk for monitoring and that mitigating controls are implemented. Fraud Prevention Strategies: - Develop, implement, and monitor fraud prevention programs, initiatives and establish mitigating controls for all RML stakeholders. - Create and enforce policies and procedures aimed at minimizing the risk of fraud for RML and our partners. - Educate internal and external RML stakeholders on fraud prevention strategies, including conducting fraud awareness training sessions. - Assess and report any vulnerability on the business systems. - Provide an independent opinion on fraud weaknesses and gaps within RMA, to avoid fraud risk. - Represent RML LRC team at various risk forums and interact with other stakeholders. Monitoring and Investigation: - Monitor and analyse transactions and activities within RML, for signs of fraud or suspicious behaviour. - Conduct extensive field investigation to gather information on claims syndicates and with collaboration with the Hawks, SAPS, Department of Home affairs, Foreign Affairs, Insurance Crime bureau, SABRIC and other external stakeholders. - Partner with RMA group investigations teams on fraud cases that affect RML. - Maintain a database of incidents and outcomes for future reference and risk analysis. Compliance and Reporting: - Ensure all fraud risk management practices are compliant with relevant regulations and standards. - Prepare and present detailed reports on fraud risks, incidents, and prevention measures to senior management and partners/stakeholders on a monthly basis. - Keep up-to-date with the latest fraud prevention techniques, technologies, and regulatory requirements. Continuous Improvement: - Review and enhance existing fraud prevention tools, techniques, and frameworks. - Stay informed on emerging fraud trends, including syndicates and implement proactive measures to safeguard the organization. - Foster and drive culture of integrity and awareness within all teams in RML, to minimize fraud risks. - Build a detection model with the data analysis obtained through past investigations and incidents and ensuring that the information gathered through investigations is embedded into the detection model. - Proactively report on key insights and use these to identify opportunities for continuous improvement and innovation. **WHAT YOU'LL BRING TO THE TABLE?** - Certified Commercial Forensic Practitioner (FP) SA (ICFP) - member of the Association Certified Fraud Examiner (ACFE) - NQF Level 7: Bachelor’s degree in Forensic Science or equivalent - Diploma in Criminal Justice & Forensic Investigations / Auditing - Proven track record with a minimum of 15 years' experience within risk and/or fraud investigations. - At least 6 years investigations experience in a fraud/forensic investigations role within the insurance industry - Minimum 3 years in a managerial position - Experience in funeral insurance and funeral parlour business would be advantageous. **Skills**: - Knowledge of business policies, processes and procedures - Understanding of due diligence, accreditations, and policy onboarding processes - Computer literacy: Advanced MS Word, Excel and Outlook - Good presentation skills and ability to interact with internal and external stakeholders and partners at all levels - Managerial and Financial Management skills **WH