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PwC Financial Crimes- Insurance Fraud-Director in Boston, Massachusetts

Specialty/Competency: Data and Analytics Technologies

Industry/Sector: Banking and Capital Markets

Time Type: Full time

Travel Requirements: Up to 60%

A career within Data and Analytics services will provide you with the opportunity to help organisations uncover enterprise insights and drive business results using smarter data analytics. We focus on a collection of organisational technology capabilities, including business intelligence, data management, and data assurance that help our clients drive innovation, growth, and change within their organisations in order to keep up with the changing nature of customers and technology. We make impactful decisions by mixing mind and machine to leverage data, understand and navigate risk, and help our clients gain a competitive edge.

Our team helps clients navigate various analytics applications to get the most value out of their technology investment and foster confidence in their business intelligence. As part of our team, you'll help our clients implement enterprise content and data management applications that improve operational effectiveness and provide impactful data analytics and insights.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As a Director, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

  • Support team to disrupt, improve and evolve ways of working when necessary.

  • Arrange and sponsor appropriate assignments and experiences to help people realise their potential and support their long-term aspirations.

  • Identify gaps in the market and spot opportunities to create value propositions.

  • Look for opportunities to scale efficiencies and new ways of working across multiple projects and environments.

  • Create an environment where people and technology thrive together to accomplish more than they could apart.

  • I promote and encourage others to value difference when working in diverse teams.

  • Drive and take ownership for developing connections that help deliver what is best for our people and stakeholders.

  • Influence and facilitate the creation of long-term relationships which add value to the firm.

  • Uphold the firm's code of ethics and business conduct.

The Insurance Fraud Financial Crimes Director will serve as a subject matter expert on the capabilities, application & implementation of Insurance Fraud Detection & Investigation solutions for insurance carriers, third party administrators, and self-insured entities. They will provide solution design and fraud strategy recommendations with customers, in support of the sales team. They will engage with customers, partners & internal resources to support the development of PwC’s product strategy.

Job Requirements and Preferences :

Basic Qualifications :

Minimum Degree Required :

Master Degree

Minimum Years of Experience :

8 year(s)

Preferred Qualifications :

Preferred Fields of Study :

Information Technology, Computer and Information Science, Computer Engineering, Computer Management, Management Information Systems

Preferred Knowledge/Skills :

Demonstrates extensive experience consulting in the financial crimes space and working in a regulatory environment by:

  • Demonstrating extensive level of ability and/or proven record of success managing insurance fraud risk, fraud prevention and detection, and/or data analytics;

  • Demonstrating knowledge of U.S. Insurance Fraud regulatory requirements;

  • Demonstrating knowledge of underwriting and claims processes across Property & Casualty Insurance Lines of Business; and,

  • Demonstrating knowledge of SIU Target Operating Models including: SIU roles and responsibilities, investigative best practices and workflows, prosecutorial requirements and procedures.

Demonstrates extensive abilities and/or proven record of success as a team leader by:

  • Applying subject matter specialization to the development and prioritization of anti-fraud strategies, analytics, models, and operations;

  • Managing multiple engagement teams and competing priorities in a rapidly growing, cross-functional, fast-paced, interactive, results-based team environment;

  • Working with our data science teams to develop fraud detection rules and/or models across multiple property, casualty, health and life insurance lines of business;

  • Supporting engagement leads in the interpretation and presentation of model results and model choice rationale;

  • Collaborating with business development teams responsible for writing and presenting proposals to prospective clients, leveraging PC applications including Microsoft Word, Excel, PowerPoint, and Project;

  • Managing and/or contributing to project planning, engagement administration, budget management, and successful completion of engagement work stream(s); and,

  • Applying subject matter specialization to the development and prioritization of anti-fraud strategies, analytics, models, and operations.

At PwC, our work model includes three ways of working: virtual, in-person, and flex (a hybrid of in-person and virtual). Visit the following link to learn more: https://pwc.to/ways-we-work.

PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.

All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

For positions in Colorado, visit the following link for information related to Colorado's Equal Pay for Equal Work Act: https://pwc.to/coloradoadvisorydirector.

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