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PwC Financial Crimes- Insurance Fraud- Senior Manager in Florham Park, New Jersey

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 Senior Manager, 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:

  • Encourage everyone to have a voice and invite opinion from all, including quieter members of the team.

  • Deal effectively with ambiguous and unstructured problems and situations.

  • Initiate open and candid coaching conversations at all levels.

  • Move easily between big picture thinking and managing relevant detail.

  • Anticipate stakeholder needs, and develop and discuss potential solutions, even before the stakeholder realises they are required.

  • Contribute technical knowledge in area of specialism.

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

  • Navigate the complexities of cross-border and/or diverse teams and engagements.

  • Initiate and lead open conversations with teams, clients and stakeholders to build trust.

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

The Insurance Fraud Financial Crimes Senior Manager will serve as a subject matter expert on capabilities, application & implementation of Insurance Fraud Detection & Investigation solutions for insurance carriers, third party administrators, and self-insured entities. They will provide solution design & 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 :

Bachelor Degree

Minimum Years of Experience :

7 year(s)

Preferred Qualifications :

Degree Preferred :

Bachelor Degree

Preferred Fields of Study :

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

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 industry-leading 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 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/coloradoadvisoryseniormanager.

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