AVP, Special Investigations Unit

USAA•San Antonio, NC

1d•Hybrid

About The Position

As a dedicated AVP, Special Investigations Unit you will develop, implement, and execute USAA Claims Security strategy for detection, prevention, and investigation of insurance fraud involving insureds, third party claimants and service providers. Develops strategies and plans in partnership with USAA leadership to ensure the support of USAA fraud strategies for experiences, service, growth, and financial strength. We offer a flexible work environment that requires an individual to be in the office 4 days per week. 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. Relocation assistance is available for this position.

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.

Nice To Haves

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

Responsibilities

Responsible for the development, implementation, and refinement of an effective P&C Fraud Program in accordance with USAA 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 Association-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.
Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.