AVP, Special Investigations Unit

Why USAA?

At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.

Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.

We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.

The Opportunity

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.

What you'll do:

• 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…