AVP Special Investigations Unit Anti-Fraud Programs

AVP Special Investigations Unit Anti-Fraud Programs

Requirements

• 8+ years SIU / insurance fraud leadership experience at a national level
• 3+ years of experience leading leaders across multiple disciplines
• Experience leading and managing all levels of staff relative to experience, tenure, and professional development
• Ability to teach, guide, coach and develop staff
• Strong strategic thinking, planning and execution abilities
• Ability to create and foster teamwork and relationship building
• Strong financial acumen
• Strong analytical skills in terms of functional, technical, and financial information
• Highly effective communication skills, both verbal and written regardless of audience demographic and size
• Experience with employee policies, procedures, and administration
• Ability to travel to business and customer locations on a national or international level as needed

Responsibilities

• Overseeing Medical Fraud Major Case, Forensic Data Analytics, Fire Investigations, and Criminal Restitution and Recovery programs
• Fostering SIU engagement with internal Data Science partners in the development of proactive fraud identification models, along with model performance monitoring and enhancement recommendations
• Continued development of internal and external fraud detection data strategies and programs
• Assist in partnership with Enterprise Risk, Internal Audit and Product Lines for fraud loss exposure identification in support of control measures
• Leading SIU strategies to identify, develop and implement vendor data applications between internal and external applications
• Engaging at industry level in fraud focused industry associations and law enforcement agencies engaged in insurance fraud detection, deterrence and mitigation strategies
• Being highly knowledgeable in areas of appropriate investigative techniques and strategies pertaining to organized fraud schemes, laws pertaining to insurance claims, mandated reporting, good-faith investigative techniques and understanding of emerging issues impacting Property & Casualty and Employee Benefits claims

Preferred Qualifications

No preferred qualifications provided.