AVP, Special Investigations Unit

Job Description

Why USAA?

At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. We’re working as one to build a great experience and make a real impact for our members.
We believe in our core values of honesty, integrity, loyalty and service. They’re what guides everything we do – from how we treat our members to how we treat each other. Come be a part of what makes us so special!
Develops, implements, and executes USAA Claims Security strategy for detection, prevention, investigation of insurance fraud involving insureds, third party claimants and service providers. Develops strategies and plans in partnership with enterprise leadership to ensure the support of enterprise fraud strategies for experiences, service, growth, and financial strength.

The Opportunity

• Identifies and manages existing and emerging risks that stem from business activities and the job role.
• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled.
• Follows written risk and compliance policies, standards, and procedures for business activities.
• Responsible for the development, implementation, and refinement of an effective P&C Fraud Program in accordance with enterprise policies and standards, including:
  • Clear and specific procedures outlining the responsibilities within P&C to support the Fraud Program
  • Periodic reporting to the internal second line of defense and governing bodies
  • Effective training and education
  • Development and maintenance of effective systems for routine fraud auditing and identification of risks.
  • Collaboration with other departments to ensure compliance issues are reported to appropriate channels for investigation and remediation.
• Sets strategy for identifying, measuring, and mitigating fraud risk for the Claims SIU organization.
• Provides executive thought leadership to identify potential gaps in the control environment that present fraud risk and vulnerability and partner with enterprise-wide stakeholders/leadership. in developing and implementing corrective action plans for remediation of risks; articulates business requirements for controls that strengthen technology and process gaps within P&C that would prevent fraud or iteratively automate detection.
• Responsible for maintaining sufficient and accurate reporting and metrics providing actionable insights on detection and investigation of insurance fraud matters
• Acts as a strategic liaison between USAA and the National Insurance Crime Bureau, Law Enforcement, State Insurance Fraud Bureaus, Industry Associations, and other organizations to promote and support insurance fraud prevention; ensures SIU makes the appropriate referrals to and where appropriate, maintains relationships with regulatory and law enforcement officials.
• Responsible for the oversight and implementation of fraud awareness training programs.
• Operationalizes the P&C Fraud Program that enables USAA to meet its legal and regulatory obligations.
• Accountable for growth of digital fraud detection capability through technology advancement and streamline investigation capabilities.
• Defines and measures appropriately scaled goals for the capability to deter, detect and investigate fraudulent activity for P&C.
• 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.
• Responsible for the affirmative litigation philosophy and individual decisions on case filing in state or federal venues.
• Ensures the timely completion of annual state level anti-fraud plans and other required regulatory reports.

What you have:

• Bachelor’s degree; OR 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.
• 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 enterprise decisions, and managing work to achieve strategic goals.

What sets you apart :

• Demonstrated success in leading a Claims SIU organization to include the development, implementation, and execution of a multi-year strategic vision for the P&C Fraud Program.
• Prior fraud investigative experience in areas of SIU and/or law enforcement – detective-level experience desired.
• CFE, FCLS, FCLA, and/or CIFI designations
• Working knowledge of AML, Sanctions, OFAC standards, cyber fraud events and applicability to P&C operations.
• Experience working with fraud prediction modeling programs and data and analytics to measure and drive business results.
• Ability to apply knowledge of NICB capabilities and experience collaborating with NICB resources
• Management experience with a distributed office and/or field operations workforce.
• Prior military experience desired.

Compensation:

USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market position. The salary range for this position is: $157,000.00-209,300.00-282,600.00.

Employees may be eligible for pay incentives based on overall corporate and individual performance or at the discretion of the USAA Board of Directors.

Long Term Incentive Plan: Cash payment for Executive level roles only, representing a cash payment which is both time and performance based.

Benefits:

At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include 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, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

Please click on the link below for more details.

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USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.