CVP, Fraud Prevention and Detection

 Job Requisition ID: 90920 

Location Designation: Hybrid - 3 days per week 

Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of being there when we’re needed most. Here, you'll design, implement, and support these solutions directly impacting employees’ lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.

Alternate locations: Philadelphia, PA (Pennsylvania); Bethlehem, PA (Pennsylvania); Dallas, TX (Texas); New York, NY (New York); Pittsburgh, PA (Pennsylvania); Tampa, FL (Florida)

This position primarily involves a hybrid work schedule - working remotely: Monday & Friday / on site: Tuesday, Wednesday and Thursday.

Under certain circumstances, will consider a remote option.

Role Overview:
 

The Corporate Vice President of Fraud Prevention and Detection will oversee the development and execution of fraud prevention and detection strategies.  This includes leading investigations and providing leadership to ensure effective mitigation and collaboration with SIU. This role is responsible for leading all GBS fraud operations and coordinating across multiple departments to maintain organizational security and compliance. The Fraud Operations Manager will be instrumental in shaping the fraud detection framework, guiding the team in fraud monitoring, prevention, and reporting, and ensuring continuous improvement of fraud detection tools and processes.  This role focuses on leadership, strategic decision-making, and cross-functional collaboration, and is a critical driver of the company’s fraud prevention efforts.

What You’ll Do:

• Develop and Implement Fraud Strategies: Design and execute fraud detection and prevention strategies for all channels of fraud (telephonic, digital, fax/paper), aligning with corporate goals and compliance requirements.
• Oversee Fraud Detection and Prevention Efforts: Supervise the review and monitoring of suspicious activity, including review of all relevant reports, unusual transactions, claims patterns, and other fraud indicators.
• Outline and Maintain a Comprehensive List of Red Flags: for all types of fraud exposure: identify theft, payment misdirection, employee theft, suspicious paperwork, claimant/beneficiary behavior, etc.
• Develop and Implement a Robust Fraud Prevention Framework: Design and continuously improve a comprehensive, step-by-step process for the prevention, identification, and mitigation of fraudulent activities, ensuring clear guidelines, best practices, and streamlined workflows across all departments.
• Enhance Existing Fraud Prevention Documentation: Review and refine the current fraud prevention process document, incorporating new insights, industry best practices, and technology advancements to ensure a more effective and up-to-date approach to fraud detection and mitigation.
• Collaborate Cross-Functionally: Work closely with departments such as Call Center, Claims, IT, and SIU to resolve fraud issues and enhance fraud detection systems.
• Vendor and Technology Management: Evaluate, select, and manage relationships with fraud detection technology vendors, ensuring that systems are updated and effective.
• Maintain and Enhance Fraud Playbook: Oversee updates to the GBS Fraud Playbook, ensuring clarity on processes and actions when fraud is suspected.
• Reporting and Stakeholder Communication: Regularly report fraud findings and recommendations to senior leadership, providing insights into trends, risks, and resolution efforts.
• Process Improvement: Lead continuous improvement initiatives to enhance fraud detection processes, tools, and training programs.
• Risk Mitigation and Compliance: Ensure fraud mitigation efforts align with NYL corporate policies, industry regulations, and compliance standards.

What You’ll Bring:

• Bachelor’s Degree Preferred
• 8+ years of experience in fraud operations and/or project management
• Proven leadership and management skills, with experience leading cross-functional teams
• Strong analytical, investigative, and problem-solving capabilities
• Expertise in fraud detection tools and technologies, and familiarity with GBS/NYL policies and systems
• Advanced proficiency in MS Excel for data analysis and reporting
• Claims background or familiarity is a plus
• Strong communication skills, capable of interacting with internal and external stakeholders at all levels
• Proven ability to make sound decisions and recommendations in high-pressure situations
• Demonstrates a commitment to confidentiality, integrity, and teamwork in all aspects of the role
• Experience in insurance or financial services, with a background in fraud prevention, AML, or compliance a plus

This position primarily involves a hybrid work schedule - working remotely: Monday & Friday / on site: Tuesday, Wednesday and Thursday.

Under certain circumstances, will consider a remote option.

#LI-KH1
#LI-HYBRID 
#LI-REMOTE

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Pay Transparency

Salary range: $125,000-$165,000 

Overtime eligible: Exempt 

Discretionary bonus eligible: Yes 

Sales bonus eligible: No 

Actual base salary will be determined based on several factors but not limited to individual’s experience, skills, qualifications, and job location. Additionally, employees are eligible for an annual discretionary bonus. In addition to base salary, employees may also be eligible to participate in an incentive program.

Actual base salary within that range will be determined by several components including but not limited to the individual's experience, skills, qualifications, and job location. In addition to base salary, employees may also be eligible to participate in an incentive program.

Our Benefits 

We provide a full package of benefits for employees – and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Click here to discover more about our comprehensive benefit options or visit our NYL Benefits Site.

Our Diversity Promise 

We believe in a diverse workforce because it is our mission to advocate for the financial security and success of people in every community. This is why diversity, equity, and inclusion (DEI) are guiding principles that are embedded in our brand and our culture. Click here to learn more about how we have been recognized for our leadership.

Recognized as one of Fortune’s World’s Most Admired Companies, New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by the Foundation. We're proud that due to our mutuality, we operate in the best interests of our policy owners. To learn more about career opportunities at New York Life, please visit the Careers page of www.NewYorkLife.com.

​Job Requisition ID: 90920