Director, Medical Claims Data Analysis

12 hours ago

Colorado Springs CO, United States USAA Full time

Why USAA?At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. As a dedicated Director, Special Investigations Unit for Property & Casualty Insurance , you will be responsible for the Claims fraud investigation strategy, program management, regional management of investigative staff and the results achieved. Develops investigative and other operational priorities, manages workload balance, develops staffing strategies, and evaluates operational results. Ensures compliance with policies and procedures contributing to fraud control objectives, as well as compliance with state insurance fraud-related laws and regulations.

We offer a flexible work environment that requires an individual to be in the office 4 days per week. Relocation assistance is available for this position.

Develops investigative and other operational priorities, manages workload balance, develops staffing strategies, and evaluates operational results.
· Directs claims investigative teams, ensures business performance and progress towards short- and long-term objectives.
· Develops and implements Claims Security operational plans/policies in conjunction with senior leadership.
· Consults with senior leadership on strategic direction for SIU.
· Responsible for communication and training tactics in support of new programs and processes.
· Regularly interacts with and influences peers and executive management on significant operational issues.
· Coordinates Claims Security Quality Assurance program. 
· Responsible for hiring, employee development, coaching, counseling, performance evaluation and all leadership and 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.

Bachelor’s degree; claims, law enforcement, etc.) 3 years of direct team lead or management experience. 
· Demonstrated team leadership, cross-functional collaboration, building business solutions, and/or claims/investigation accountabilities.
· Experience using, interpreting, solutioning and leading with data.
· Proficiency at investigative protocols and procedures that would include compliant claims or fraud investigations to the specific state and regulatory requirements.
· Possess in-depth knowledge of insurance policies and broad understanding of procedures related to SIU investigations.
· Capability to analyze data, conduct root causes analysis, identify root causes, and recommend action plans and strategies to overcome operational obstacles and achieve strategic targets.
·Ability to act as a subject matter expert to the claims organization to provide guidance and advice on a wide range of fraud related risk and communicating effective courses of action.
· Fundamental knowledge of advanced fraud analytics.
· SIU Project experience.
· Experience managing people leaders in either Law Enforcement or SIU.
· Deep network across P&C industry.
· 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. 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. Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. 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.

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