Leader, Special Investigations Unit (SIU) Transformation
Leader, Special Investigations Unit (SIU) Transformation
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$ 100700 - 151000
1 Vacancy
Job Description
ABOUT THE NORTH AMERICA LEGAL AND COMPLIANCE TEAM:
We seek highly motivated individuals to join our team who exhibit the best-in-class competencies listed below and embody theChubb Legal and Complianceculture.
- We deliver high quality work product services and solutions that demonstrate understanding of the needs and requirements of our business partners and support achievement of team goals.
- We adapt to changing business needs and environments through a proactive flexible approach that achieves results and strikes the proper balance among all constituencies.
- We demonstrate character integrity and professionalism both within a team environment in Legal and Compliance and in fulfilling our responsibilities to our business partners.
- We build collaborative trusting relationships with team members and business partners through superior communication skills empathy and respect.
- We independently manage work responsibilities through commitment dedication and accountability and display an on-going commitment to self-improvement.
KEY OBJECTIVE:
The Leader of SIU Transformation will lead efforts to update and modernize Combineds SIU Department. This individual will work with Combineds Claims Department and existing SIU staff to identify and combat instances of insurance fraud. The Leader will work collaboratively with the Claims Department to develop new ways to quickly identify and combat potential fraud in a business environment that values speed and service allowing us to quickly process and pay legitimate claims for our policyholders. This individual will report to the Chief Compliance Officer.
MAJOR RESPONSIBILITIES:
- Work with the Chief Compliance Officer to develop and execute strategy.
- In coordination with the Legal Department and Chief Compliance Officer assist the business in complying with regulatory requirements related to claim fraud investigation and reporting.
- Develop new tools and strategies to combat emerging insurance fraud risks including the risks associated with the use of AI to perpetrate insurance fraud.
- Develop new processes and tools to improve fraud detection while supporting efforts to streamline the claims adjudication process allowing the Company to quickly pay all legitimate claims.
- Manage routine and escalated regulatory interactions and communications including collaboration with state insurance departments and law enforcement.
- Work collaboratively with Combineds Claims Department to develop new processes and strategies to combat claims fraud.
- Train and educate claims staff and other stakeholders on emerging trends in insurance fraud.
- Develop and maintain relationships with and provide timely guidance and advice to business partners.
- Assist in SIU reporting to both Combined management and state insurance departments.
- Assist in the preparation of responses to regulatory inquiries complaints and examinations.
- In coordination with Combineds Legal Department outside counsel and law enforcement personnel assist with high profile claim fraud investigations.
- Conduct regular monitoring and testing to confirm that adequate controls are in place to prevent claims fraud.
- Coordinate activities between Combineds SIU staff and Chubb SIU staff.
- Conduct trending analysis using data analytics and other reporting mechanisms to identify potential issues.
- Report and escalate issues and developments as required.
QUALIFICATIONS:
- 10 years of insurance industry experience preferably in the areas of accident and health related products.
- Bachelors degree or equivalent experience experience and/or professional designations related to insurance claims handling insurance fraud and SIU.
- Demonstrated understanding ofthe accident and health and life insurance regulatory environment including HIPAA GLBA and other applicable privacy and data security regulations.
- Strong analytical and technical skills in using data analytics and a deep understanding of insurance claims and fraud issues.
- Demonstrated ability to develop relationships with business partners across the organization.
- Ability to consistently execute and deliver results.
- Ability to manage multiple projects in a dynamic business environment.
- Strong knowledge of MS Project Excel PowerPoint Word; and other legal/compliance research tools.
The pay range for the role is $100700 to $151000. The specific offer will depend on an applicants skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package more details on which can be foundon our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.
Employment Type
Full-Time
