The Senior Executive Manager – Fraud will drive the overall fraud agenda as a 2nd line of defence with regard to various types of fraud affecting Bupa Arabia arising from providers, customers , suppliers/vendors and internal employees so as to ensure all mitigation steps are put in place, plus other Operational risk Management activities.Fraud Risk Prevention
- Design a robust Fraud Risk Management Framework in line with regulatory and risk management standards in order to enforce the zero tolerance approach against internal and external fraud & to continuously assess the framework.
- Develop an internal network of good business conduct and fraud champions that would help in developing a culture of fraud awareness what would help in promoting and implementing the framework.
- Provide expert guidance on the development of policies and roll out of training and awareness campaigns to enhance the control environment.
- Implement “best in class” tools and processes to manage and prevent fraud risks and minimize losses.
- Build tracking and trending process of all fraud reports and other business misconduct to the Board, Committees, and members of senior management.
- Roll out Fraud Risk assessment to enable Bupa Arabia to identify its high relevant fraud risks that are not properly mitigated and along with senior management to put in place a remediation plan and road map for implementation.
Fraud Risk Detection
- Facilitate with Legal Affairs Department to ensure the effectiveness of the design and implementation of the Speak Up program, as a fraud detective tool.
- Oversee relevant control monitoring and detection activities, including the development of IT solutions to monitor controls and detect potential fraud issues.
Fraud Risk Response
- Oversees investigations processes and report results with respect to fraud allegations, recommend remedial activities and reporting lessons learnt.
- Ensure documents, reports, tools, gadgets, computers, equipment, etc., involved purportedly in committing fraud are protected and preserved that would later be used as proof or evidence during investigation and legal proceedings.
- Cordinate with Legal and Internal Audit Departments to ensure that the fraud case in determining the fraud case; escalate to the proper company authorities to obtain guidance on the next action to take such as referring the case to the police or the court.
- Ensure designed penalties and disciplinary actions that are proportionate to the offense in situation where the case can be internally and amicably resolved.
- Ensure independency, objectivity and conflicts of interest safeguarding during investigation even when fraud involves Senior or Executive levels (e.g., CET, board member, auditors, counsels, etc.)
Fraud Incident Management
- Manage fraud incidents framework to support identification, escalation and reporting in a timely fashion via defined governance routes including executive management and the relevant committees
- Coordinate with assigned investigators to investigate and resolve fraud risk incidents.
- Provide assurance that all fraud critical Incidents are managed and reported in line with the Critical Incident Policy.
- Liaison with Law Enforcement for all internal and external fraud investigations.
- To advise on actions to take as appropriate to mitigate and manage financial, customer, regulatory and reputational impact from identified fraud incidents.
Management of Insurable Fraud risks
- Manage the activities of insuring transferable fraud risks; provide advice and guidance as necessary.
- Participate in the annual fraud risk funding/insurance program
- Assist the management of the annual insurance renewal process, ensuring the collection of accurate fraud risk exposure data in various part of the business & start the process of claims against fraud incidents and ensure proper recoveries.
- Start the process of claims against fraud incidents and ensure proper recoveries.
- Perform risk management activities (assessment, review, analysis)
- Ensure implementation of robust and fit-for-purpose controls
- Ensure business remains compliant with BA’s KPIs,
- Provide advisory and help in partnering with other business units to remediate key risks and strategic projects.
- Support the Risk Champions in the business to enhance the control environment and close open observations.
- Coordinate with the IA team on a monthly basis to ensure accurate reporting and support timely completion.
- Support preparation of extension forms for the business and obtain relevant approvals.
- Report Monthly summary of Audit KPIs to the CET.
SkillsYears of Experience
- Minimum 8 years’ experience in fraud handling within multi-line financial services company; at least 5 years direct experience in the handling fraud incidents
- Intimate knowledge of internal business processes, specifically in the financial and or insurance services industry
- Previous experience as a banker, legal or audit examiner is a plus
- Experience with reporting processes to board committees and corporate governance standards
- Preferably, with significant experience likely gained within a financial institution with exposure in areas like financial crime, money laundering, fraud risk management, compliance, and or internal audit functions.
- General understanding of fraud risk factors affecting insurance companies & familiarity with fraud risk-oriented regulations (e.g. Solvency II).
- Leadership skills, including ability to manage fraud risk, compliance and control activities in a complex financial operation.
- Ability to exercise oversight over governance, fraud risk, compliance and control arrangements, desirable in a complex financial operation.
- Problem-solving and decision-making skills, with the ability to analyze complex information to identify the key issue/action and drive resolution.
- Preferably significant financial services experience, likely gained within a financial institution.
- Bachelor’s degree (Engineering / Criminal justice / Business Administration, Security management, or other related field.
- Hold internationally accepted relevant certification i.e. Certified Fraud Examiner (CFE)
- Master’s Degree will be an added advantage
About Bupa Arabia
Bupa Arabia is part of Bupa Group which provides healthcare services for over 70 years to more than 30 million members in 190 countries by 80 thousand employees. We pride ourselves for having an exceptional work environment that attracts talents and develops leaders to create innovative healthcare products and services which have enabled us to assume market leadership in Saudi Arabia.
Our aim is to be the best healthcare company in the Arab world. Come and join our team of Saudi men and women who are innovating new healthcare products and services every day and serve our customer segments – Saudi families, SME and large corporates – in an exceptional way to make all their experiences with us positive and to raise the bar when it comes to health insurance and the entire healthcare sector.
We continuously and effectively develop our people to create leaders at all levels and in all departments and we motivate and incentivize them to achieve higher performances.
Bupa Arabia for Cooperative Insurance Company, CR# 403017888.
Head Office: 3538 Alkhalideya, Noor Elihsan, Unit 1, Jeddah 7505-23423
The authority license number ت م ن/20088/18 - License Date: 09/08/ 1429هـ
Bupa Arabia, Prince Saud AlFaisal St. Al Khalediya District
P.O.Box 23807 Jeddah 21436, Saudi Arabia
Bupa Arabia is a company subject to the supervision and control of the Saudi Central Bank.