AVP of Claims, Fraud & Financial Crimes – Life, Health & Annuities

USAA

. Lead Claims and the Special Investigations Unit with end-to-end accountability for claims administration, complex claim adjudication, fraud prevention and investigation, AML, financial crimes, and operational controls .

Posted 10/22/2026full-timeUnited StatesLead💰 $195,230 - $351,410 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive expertise in claims administration, fraud prevention, and financial crime management within Life Insurance and Health Insurance sectors. Proven ability to lead high-performing teams, ensure regulatory compliance, and drive operational efficiency through data analytics and process improvement.

Highest-signal resume keywords

Claims AdministrationFraud PreventionFinancial Crimes ManagementLeadership ExperienceRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Complex Claim AdjudicationOperational Risk ManagementData AnalyticsProcess ImprovementPerformance ManagementGovernance FrameworksInvestigation PracticesAML ComplianceFraud DetectionOperational Controls

Soft Skills

Analytical SkillsProblem-SolvingCommunication SkillsJudgment SkillsInfluencing Skills

Tools & Technologies

Performance MetricsAutomation ToolsWorkflow Improvement Technologies

Industry Keywords

Life InsuranceHealth InsuranceAnnuityBSA ComplianceRegulatory RequirementsInsurance OperationsSpecial Investigations UnitHigh-Risk ClaimsMember AdvocacyOperational Efficiency

About the role

Key responsibilities & impact

Lead Claims and the Special Investigations Unit with end-to-end accountability for claims administration, complex claim adjudication, fraud prevention and investigation, AML, financial crimes, and operational controls
Shape claims administration and financial crime prevention across Life Insurance, Health Insurance, and Annuity businesses
Lead execution and continual enhancement of claims programs, policies, procedures, and operational practices
Ensure claims processes balance member advocacy, regulatory compliance, operational efficiency, and financial stewardship
Oversee investigation, evaluation, adjudication, and resolution of complex, contestable, sensitive, high-risk, and high-value claims
Maintain governance frameworks, operational controls, and quality standards for consistent and accurate claims decisions
Provide decision authority for complex claims, including settlements exceeding established authority limits
Lead fraud prevention, detection, investigation, reporting, governance, monitoring, and case management programs
Drive fraud risk management strategies and control frameworks
Serve as the primary Life Company leader for AML program execution and oversight
Ensure compliance with BSA, AML, fraud, and insurance regulatory requirements
Support regulatory examinations, audits, reviews, and remediation
Identify, assess, monitor, and escalate operational, regulatory, compliance, and reputational risks
Collaborate with Operations, Legal, Compliance, Enterprise Risk, Product Management, Technology, regulators, auditors, and governance forums
Use metrics, analytics, and performance data to improve claims outcomes, fraud detection, member satisfaction, and operational efficiency
Lead continuous improvement, automation, workflow improvement, and technology initiatives
Establish and monitor performance indicators for claims and fraud operations
Lead, develop, coach, mentor, and manage high-performing teams
Oversee workforce planning, succession planning, and employee engagement initiatives

Requirements

What you’ll need

Bachelor's degree, or 4 additional years of related experience beyond the minimum required may be substituted in lieu of a degree
10+ years of progressive experience across Life Insurance claims, fraud prevention, financial crimes, risk management, and/or related insurance operations
6+ years of leadership experience building and leading claims, SIU/fraud, financial crimes, risk, compliance, or complex operational teams
Deep knowledge of Life Insurance, Health Insurance, and/or Annuity claims administration
Experience managing contestable claims, complex investigations, high-risk settlements, and claims involving potential fraud or material misrepresentation
Strong knowledge of fraud prevention, investigative practices, AML, financial crimes, operational risk, and governance and control frameworks
Experience with process improvement, data and analytics, automation, technology, and disciplined performance management
Experience establishing and monitoring performance standards across claims quality, accuracy, cycle time, productivity, customer experience, investigative effectiveness, and financial outcomes
Experience working with state insurance regulators, auditors, Compliance, Legal, Risk, and other control partners in highly regulated environments
Ability to balance member advocacy with investigative rigor, regulatory requirements, risk management, and financial stewardship
Strong executive presence and ability to influence senior stakeholders and drive complex decisions across a highly matrixed organization
Exceptional analytical, problem-solving, communication, and judgment skills
USAA does not provide visa sponsorship; applicants must not require immigration support now or in the future
What Sets You Apart qualifications include deep leadership experience within a prominent Life Insurance organization; broad claims expertise; leadership of Special Investigations, fraud prevention, and financial crimes capabilities; modernization of claims and investigative operations; leadership of large, multi-layered Claims and Special Investigations organizations; and extensive experience partnering with Legal, Compliance, Risk, regulators, and other control functions

Benefits

Comp & perks

Remote or hybrid flexibility may be available for active-duty military spouses, consistent with applicable policy and business needs
Relocation assistance
Pay incentives based on overall corporate and individual performance, at the discretion of the USAA Board of Directors
Long Term Incentive Plan: cash payment for Executive level roles, both time and performance based
Comprehensive medical, dental and vision plans
401(k)
Pension
Life insurance
Parental benefits
Adoption assistance
Paid time off program
Paid holidays
16 paid volunteer hours
Wellness programs
Career path planning
Continuing education