Director, Special Investigations Unit
11 - 15 years experience • Financial Services
Spread Your Wings
We are the Duck. We inspire and are inspired, listen and respond, empower our people, give back to our community and, most importantly, celebrate every success along the way. We do it all – The Aflac Way.
Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized by Fortune magazine as one of the 100 Best Companies to Work For in America for 18 consecutive years, one of the Best Workplaces for Millennials in 2015 (the inaugural year of the award) and one of America's Most Admired Companies for 15years.
Our business is about being there for people in need. So, ask yourself: Are you the Duck? If so, there’s a home — and a flourishing career — for you at Aflac.
Principal Duties & Responsibilities
Effectively plans and directs the delivery of fraud investigations involving internal employees, agents and customers; manages the gathering and analysis/interpretation of data pertaining to fraudulent activity; reviews problem areas and provides the strategic vision for swift resolution and proactive prevention for the future, develops mitigation strategies, and assists in the implementation of actions to resolve problems; directs mandatory reporting of fraudulent activity to the appropriate department of insurance, local, state, and federal law enforcement agencies
Directs the interpretation of data and reports pertaining to the overall operation of the Special Investigation Unit and the completion of reports summarizing activities and trends; directs the independent review of problem situations, development of solutions, and implementation of action plans to resolve challenges and ensure customer satisfaction; develops and reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality
Works closely with the Director, Aflac Trust to assist with the identification and prioritization of fraud risks within the organization based on industry trends as well as Aflac’s operational environment, prior fraud activity, and the internal control structure
Reviews stays abreast of, and maintains an understanding of state and federal insurance statutes, regulations, and internal policies to ensure compliance
Evaluates the training efforts of the Special Investigation Unit to ensure that the necessary educational tools are provided to employees; partners with corporate training and other business unit resources to identify and communicate training needs. Oversees implementation of required anti-fraud training
Coaches, mentors, trains and transfers knowledge to others within the SIU and related departments; Solicits innovative ideas for potential fraud recognition, referrals and investigations to improve the department’s and the corporation’s performance
Evaluates business technology requirements and enhancement possibilities; recommends viable technological solutions, modification, and applications to support anti-fraud efforts; Facilitates effective communication with the various Departments of Insurance
Performs other duties as required
Education & Experience
Bachelor’s degree in criminal justice, business administration, business management, or a related field and ten + years of professional job-related work experience (Internal Audit, insurance, fraud investigation, etc.) or an equivalent combination of education and experience and five years in a senior professional leadership capacity
Designation/certification in one or more of the following: Certified Fraud Examiner (CFE), Fraud Claims Law Specialist (FCLS), Health Care Anti-Fraud Associate (HCAFA), Certified Insurance Fraud Investigator (CIFI) (strongly preferred)
Certification in Lean and/or Six Sigma (preferred)
Job Knowledge & Skills
Broad knowledge of fraud as it relates to the insurance business; understanding and experience with market conduct examinations
Understanding and experienceworking with and communicating with Departments of Insurance (DOIs)
Ability to balance diplomacy, tact and sensitivity with the necessary diligence, persistence and tenacity required to thoroughly investigate and report on business operations, conduct and actions that may prove to be abusive or fraudulent in nature
Ability to capture and analyze significant amounts of data from a variety of diverse and disparate IT systems, platforms, databases and infrastructures
Excellent presentation, oral, written, and interpersonal communication skills to effectively interact with all levels of management, internal and external customers, and agency representatives collecting or providing information; Ability to facilitate discovery events and categorize, prioritize, quantify and document results
Ability and willingness to travel
Action Oriented, Customer Focus, Adaptability, Listening, Ethics and Values, Integrity and Trust
Core Director Competencies
Drive for Results, Informing, Building Effective Teams, Developing Direct Reports, Hiring & Staffing, Motivating Others
Functional/Technical, Negotiating, Perseverance, Perspective
Aflac is known for treating our employees exceptionally well. As one of the leaders in the insurance industry, we’re able to offer one of the most comprehensive health benefits packages available in corporate America, including free coverage from one of our pioneering insurance products, the Aflac Cancer policy. Our employees also enjoy a host of other benefits, including advancement opportunities, opportunities for continued education and professional development, merit increases and performance bonuses, profit-sharing401(k), stock purchase plans, and many more.