Director, Special Investigations Unit (SIU) – Life Company Fraud

Why USAA?

The Opportunity

This job profile is designated as a Sensitive Position. Sensitive Positions are those positions in which individuals have the authority and ability to conduct in-scope activities (movement of USAA or Member funds) as defined within the Enterprise Sensitive Positions Mandatory Time-Away Compliance Policy. Employees in Sensitive Positions are required to fulfill a Mandatory Time-Away (MTA) requirement of 10 consecutive business days each calendar year.

As a dedicated with Director, Special Investigations Unit (SIU), you will be responsible for Life, Annuity & Health claims and fraud investigation programs and management of the Life Special Investigation Unit (SIU) staff. Develops investigative and other operational priorities, manages workload balance, develops staffing strategies and evaluates operational results. Creates and maintains industry, law enforcement and other business relationships.

We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based San Antonio, TX., Phoenix, AZ., Tampa, FL. or Colorado Springs, CO. Campuses. If employee is located on Phoenix, Tampa or Colorado Springs campus, they will be required to travel to San Antonio Campus up to 25% of time.   Relocation assistance is not available for this position.

What you'll do:

• Provides guidance to staff in interpreting procedures, guidelines, and training reference materials.

• Oversees decisions made within the claims and benefits process.

• Approves claims within assigned authority limit.

• Directs claim investigation team and ensures business performance and progress towards short and long term CoSA/Corporate objectives.

• Develops and implements Claims Security strategic and operational plans/policies in conjunction with senior management. Identifies emerging fraud trends and develops new fraud investigation programs and processes. 

• Responsible for communication and training strategies in support of new programs and processes.

• Regularly interacts with and influences peers and executive management on significant fraud and operational issues.

• Oversees process improvements in the Claims and Fraud investigation functions. 

• Develops collaborative internal and external relationships with enterprise business partners, vendors, industry, governmental and law enforcement agencies.

• Responsible for hiring, employee development, coaching, counseling, performance evaluation and all management related functions.

• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

• Bachelor’s degree OR 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree. (Total of 12 years of experience without bachelor’s degree)

• 8 years relevant business experience to include 3 years Claims and/or Insurance Fraud experience.

• 3 years of direct team lead or management experience

What sets you apart:

• US military experience through military service or a military spouse/domestic partner

• 6 years of experience leading a Life Special Investigation or Fraud Program.

• Fundamental knowledge of advanced fraud analytics.

• 4 years of SIU Project Experience to include broad understanding of procedures related to SIU investigations.

• Knowledge and experience in fraud waste and abuse investigations of Medicare Supplement Claims.

• Experience in life claims fraud or financial crimes investigations.

• Excellent communication, interpersonal and problem-solving skills.

• Exceptional analytical and decision-making acumen.

• Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) designation is a plus.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

What we offer:

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is: $109,130 - $202,500.

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning, and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, please visit our benefits page on USAAjobs.com.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.