Fraud & Claims Call Monitoring Lead

The Fraud & Claims Call Monitoring Lead is responsible for leading quality assurance and control activities while driving business outcomes, supporting team performance, and acting as a key liaison between frontline QC staff and leadership. This role requires strong leadership presence, independent decision-making, and the ability to influence business processes and outcomes.

Operates with minimal oversight, leads critical initiatives, and ensures alignment between QC activities and broader business, risk, and customer impact objectives.

• Operates independently, presenting findings, insights, and recommendations with minimal leadership support
• Serves as a subject matter leader in meetings, reviews, and cross‑functional engagements
• Ensures consistency, accuracy, and alignment in QC practices and outputs

• Champions corporate and business‑line initiatives impacting QC, including AI and process modernization
• Leads Business Line Reviews (BLRs) and stakeholder meetings independently
• Drives closed‑loop resolution of identified issues impacting customers or business outcomes
• Translates QC findings into actionable insights that influence business decisions

• Develops and delivers training plans and materials for new and existing colleagues
• Supports hiring and onboarding activities (interviews, access setup coordination)
• Acts as a primary escalation point and buffer between team members (S3, S4, P1) and leadership
• Conducts spot checks and peer reviews to ensure quality and consistency
• Coaches team members using findings to improve performance and capability
• Owns performance management administrative activities, including tracking key metrics
• Leads by example, reinforcing professionalism, accountability, and positive team behaviors

• Identifies trends, themes, and complex issues across QC results
• Performs fact‑based analysis to develop and recommend solutions to leadership
• Ensures issues are fully resolved, not just documented
• Leads decision support efforts for escalations, exceptions, and disputes
• Provides input into business decisions related to corrective actions and risk mitigation

• Drives team outcomes and ensures timely completion of work across all levels (S3, S4, P1)
• Maintains limited individual QC workload, focusing primarily on leadership and oversight responsibilities
• Leads walkthroughs and supports audits, risk reviews, and GenAI‑related initiatives
• Ensures readiness for internal and external audits through strong documentation and execution

• Models strong professionalism, sound judgment, and collaboration
• Builds trust as a reliable escalation and advisory resource
• Effectively navigates sensitive or complex conversations with business partners and stakeholders
• Acts as a bridge between QC teams and leadership, ensuring clarity and alignment

• Required Qualifications
  • 1‑2 years experience in Fraud or Claims operations or 1‑2 years of QC experience within a financial services environment
  • Advanced understanding of QC methodologies, controls, and business processes
  • Strong analytical skills with the ability to interpret trends and drive business insights
  • Demonstrated leadership capability without direct authority (influence‑based leadership)
  • Experience leading meetings, presentations, and cross‑functional discussions independently
  • Strong communication skills (written and verbal), especially in translating data into business impact
  • Proven ability to manage competing priorities and drive outcomes
  • Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms)

• Hours per Week: 40
• Work Schedule:
  
  Hybrid 4 Days in Office – Monday‑Friday 8:00am‑5:00pm

Citizens, its parent, subsidiaries, and related companies (Citizens) provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, ancestry, color, citizenship, physical or mental disability, perceived disability or history or record of a disability, ethnicity, gender, gender identity or expression, genetic information, genetic characteristic, marital or domestic partner status, victim of domestic violence, family status/parenthood, medical condition, military or veteran status, national origin, pregnancy/childbirth/lactation, colleague’s or a dependent’s reproductive health decision making, race, religion, sex, sexual orientation, or any other category protected by federal, state and/or local laws.

At Citizens, we are committed to fostering an inclusive culture that enables all colleagues to bring their best selves to work every day and everyone is expected to be treated with respect and professionalism. Employment decisions are based solely on merit, qualifications, performance and capability.