AVP of Claims, Fraud & Financial Crimes – Life, Health & Annuities

USAA•San Antonio, TX

4d•$195,230 - $351,410•Hybrid

About The Position

USAA Life Insurance Company is seeking an executive to lead claims administration and financial crime prevention across its Life, Health, and Annuity businesses. Reporting to the Vice President of LifeCo Operations, the AVP leads the Claims and Special Investigations Unit (SIU) teams and is accountable for claims administration, complex claim adjudication, fraud prevention and investigation, Anti-Money Laundering (AML), financial crimes, and related operational controls. The role oversees claims from routine matters through complex and contestable claims requiring investigation, medical record review, fraud assessment, legal interpretation, or regulatory expertise. The AVP is responsible for ensuring claims are handled with speed, accuracy, empathy, and integrity while maintaining appropriate controls and protecting members and the financial strength and reputation of USAA Life Company. The AVP leads the evolution of fraud detection, investigation, AML, and financial crimes capabilities, using data, analytics, technology, and process improvement to identify suspicious activity, improve investigative effectiveness, and support consistent decisions. The position establishes operating strategies, governance, performance disciplines, and controls across Life Insurance, Health Insurance, and Annuity products, working closely with Operations, Legal, Compliance, Enterprise Risk, Product Management, and Technology. The position is based in San Antonio, Texas; Charlotte, North Carolina; or Phoenix, Arizona. The work environment is flexible, with an in-office requirement of four days per week. Relocation assistance is available. The salary range is $195,230 to $351,410, and employees may be eligible for performance-based incentives. USAA does not provide visa sponsorship for this position.

Requirements

Bachelor's degree, or four additional years of related experience beyond the minimum required may be substituted for a degree.
At least 10 years of progressive experience across Life Insurance claims, fraud prevention, financial crimes, risk management, and/or related insurance operations.
At least 6 years of leadership experience building and leading claims, SIU/fraud, financial crimes, risk, compliance, or complex operational teams.
Deep knowledge of Life Insurance, Health Insurance, and/or Annuity claims administration, including regulatory, operational, and customer considerations associated with complex claims.
Demonstrated experience managing contestable claims, complex investigations, high-risk settlements, and claims involving potential fraud or material misrepresentation.
Strong knowledge of fraud prevention, investigative practices, AML, financial crimes, operational risk, and related governance and control frameworks.
Ability to strengthen claims and investigative operations through process improvement, data and analytics, automation, technology, and disciplined performance management.
Experience establishing and monitoring performance standards for claims quality, accuracy, cycle time, productivity, customer experience, investigative effectiveness, and financial outcomes.
Experience working with state insurance regulators, auditors, Compliance, Legal, Risk, and other control partners in highly regulated environments.
Ability to balance member advocacy with investigative rigor, regulatory requirements, sound risk management, and financial stewardship.
Executive presence and ability to influence senior stakeholders and drive complex decisions across a highly matrixed organization.
Strong analytical, problem-solving, communication, and judgment skills, particularly in complex or sensitive claims and investigative matters.

Nice To Haves

Deep leadership experience within a prominent Life Insurance organization, with end-to-end accountability for large-scale claims operations and understanding of the policyholder journey, regulatory environment, and complexities of life claims.
Broad claims expertise across Life Insurance, Annuities, and/or Health Insurance, including complex and contestable claims, beneficiary disputes, medical record reviews, high-risk settlements, and sensitive member or beneficiary situations.
Leadership of Special Investigations, fraud prevention, and financial crimes capabilities, with experience strengthening investigation, detection, escalation, and control frameworks.
Success modernizing claims and investigative operations through process redesign, data and analytics, automation, and technology, with measurable improvements to accuracy, cycle times, investigative effectiveness, member experience, and operational efficiency.
Track record of leading large, multi-layered Claims and Special Investigations organizations and developing leaders while fostering member advocacy, empathy, investigative rigor, sound judgment, accountability, and disciplined risk management.
Extensive experience partnering with Legal, Compliance, Risk, regulators, and other control functions on complex claims, fraud, AML, and financial crime matters, including matters with significant regulatory, financial, or reputational implications.

Responsibilities

Lead execution and continual improvement of claims programs, policies, procedures, and operational practices across Life Insurance, Health Insurance, and Annuity products.
Ensure claims processes balance member advocacy, regulatory compliance, operational efficiency, and financial stewardship.
Oversee investigation, evaluation, adjudication, and resolution of complex, contestable, and sensitive claims.
Maintain claims governance frameworks, operational controls, and quality standards to support consistent and accurate decisions.
Identify opportunities to improve claims processes, service delivery, and member outcomes through process optimization and technology.
Provide leadership and decision authority for complex, high-risk, contestable, and high-value claims, including settlements exceeding established authority limits.
Partner with Legal, Medical, Compliance, and Risk stakeholders on claims with elevated legal, regulatory, financial, or reputational risk.
Review claims trends and operational metrics to identify opportunities for improved outcomes and risk mitigation.
Ensure timely and fair claim resolution in accordance with regulatory requirements and internal standards.
Lead fraud prevention, detection, investigation, and reporting programs for Life Company products and services.
Oversee fraud governance, monitoring, investigative processes, and case management practices.
Implement fraud risk management strategies and control frameworks addressing operational, business, and financial risks.
Partner with Enterprise Fraud, Compliance, Legal, and Risk Management to strengthen fraud prevention and regulatory compliance.
Monitor emerging fraud threats, industry trends, and financial crime risks, and recommend program enhancements.
Lead execution and oversight of Life Company AML programs and related regulatory requirements.
Ensure compliance with applicable Bank Secrecy Act (BSA), AML, fraud, and insurance regulatory requirements.
Partner with Enterprise Compliance, Legal, and Risk to implement AML policies, standards, and controls in Life Company operations.
Maintain awareness of regulatory developments affecting claims, fraud, AML, and financial crimes programs.
Support regulatory examinations, audits, and reviews, and ensure timely remediation of identified issues.
Identify, assess, monitor, and escalate operational, regulatory, compliance, and reputational risks associated with claims and fraud activities.
Collaborate with business partners to implement risk mitigation strategies and sustainable control environments.
Support interactions with state insurance departments, regulatory agencies, external auditors, and internal governance forums.
Keep operational practices aligned with applicable laws, regulations, and company policies.
Use operational metrics, analytics, and performance data to improve claims outcomes, fraud detection, member satisfaction, and efficiency.
Lead continuous improvement initiatives focused on quality, productivity, compliance, and service delivery.
Partner with Technology and Operations to implement automation, workflow improvements, and other performance-enhancing solutions.
Establish and monitor performance indicators for claims and fraud operations.
Lead, develop, and inspire teams through coaching, mentoring, performance management, and career development.
Create a culture of accountability, collaboration, operational excellence, and continuous learning.
Build organizational capabilities to support business growth, evolving risks, and regulatory expectations.
Oversee workforce planning, succession planning, and employee engagement initiatives for assigned teams.

Benefits

Comprehensive medical, dental, and vision plans
401(k)
Pension
Life insurance
Parental benefits
Adoption assistance
Paid time off program
Paid holidays
16 paid volunteer hours
Wellness programs
Career path planning
Continuing education
Performance-based pay incentives may be available
Long Term Incentive Plan cash payment for executive-level roles, based on time and performance
Relocation assistance