Fraud Specialist

About the role

The Opportunity at USAA involves developing, implementing, and refining an effective P&C Fraud Program. This includes clear and specific procedures, periodic reporting, effective training and education, and collaboration with other departments to ensure compliance issues are reported and remediated.

Responsibilities

• Develops strategies and plans in partnership with USAA leadership to ensure the support of USAA fraud strategies for experiences, service, growth, and financial strength.
• Maintains sufficient and accurate reporting and metrics providing actionable insights on detection and investigation of insurance fraud matters.
• Collaborates with the National Insurance Crime Bureau, Law Enforcement, State Insurance Fraud Bureaus, Industry Associations, and other organizations to promote and support insurance fraud prevention.
• Ensures the timely completion of annual state level anti-fraud plans and other required regulatory reports.
• Operationalizes the P&C Fraud Program that enables USAA to meet its legal and regulatory obligations.
• Designs and implements standardized, repeatable, and scalable tools and processes for the SIU ensuring identification of opportunities for efficiency and automation.
• Stays abreast of industry developments, emerging schemes, and technological and regulatory developments, to implement proactive efforts.
• Defines and measures appropriately scaled goals for the capability to deter, detect and investigate fraudulent activity for P&C.
• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

Requirements

• Bachelor's degree; OR 4 years of relevant education and/or experience.
• 10 years of progressive related experience in developing strategies, managing major initiatives to include operational oversight of P&C claims, fraud investigations, claims litigation/legal process & state regulation requirements and delivering results within a complex matrix environment.
• 6 years of people leadership experience in building, managing and/or developing high-performing teams.
• Experience collaborating with key internal and external resources, business partners and stakeholders (including federal/state agencies and Industry Associations/Bureaus), influencing decisions and managing teams to achieve strategic goals.
• Demonstrated success in leading and developing the delivery of cross-functional programs, strategies, and teams ensuring that USAA establishes, deepens, and retains a best-in-class fraud prevention, detection, and investigation posture in a complex and highly regulated environment.
• Executive-level business and technical acumen in the areas of effective claims investigations, claims risk and compliance, integrated change management and front-line communications leading to operational excellence.
• Demonstrated knowledge and compliance with state laws and regulations pertaining to insurance fraud, good faith claims handling or affirmative litigation.
• Comprehensive knowledge of industry-related competitive/regulatory environment and claims/insurance operational risk.
• Experience applying expert P&C knowledge, collaborating with key resources and stakeholders, influencing USAA decisions, and managing work to achieve strategic goals.

Qualifications

• SIU, Fraud (Internal or External), Strategy or Business Risk and Controls experience within the insurance industry.
• Experience working with agencies, external partners (NICB), external vendors (Verisk) and applicable associations.
• Proven ability to lead and develop high-performing teams in a heavily matrixed organization.
• Exceptional communication and executive presence, with the ability to build trust, navigate complex stakeholder environments, and influence at the C-suite level.
• US military experience through military service or a military spouse/domestic partner.

Skills

• Expert P&C knowledge.
• Collaboration with key resources and stakeholders.
• Influencing USAA decisions.
• Managing work to achieve strategic goals.

Benefits

• Comprehensive medical, dental and vision plans.
• 401(k).
• Pension.
• Life insurance.
• Parental benefits.
• Adoption assistance.
• Paid time off program with paid holidays plus 16 paid volunteer hours.
• Variety of wellness programs.
• Career path planning and continuing education.

Pay

The salary range for this position is: $195,230-$351,410.

Schedule

This position can be based in one of the following locations: San Antonio (preferred location), TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL.