Lead- Assistance Fraud Management (Europe, Americas)

Primary objectives include the evolvement of Anti-Fraud expertise and the enablement of bundling knowledge and cross learning of best practices throughout the organization. In addition, the continuous conduct of Fraud analysis on a local level and the execution of Fraud trainings and the implementation of Anti-Fraud measures or tools are an integral part of this role.

1. Strategy Development:

• Drive the ‘Zero Tolerance’ policy across the BUs and the GCCs in the regions allocated. Must leverage all available means of communication to reinforce the same.
• Always ensure consistent interpretation of the Fraud Management Functional Rules, its implementation and adherence to the key principles.
• Assessment of each BU and the GCC in the regions on fraud maturity. Learn the remedial measures required and continuously drive actions to enhance the maturity. This helps to identify and evaluate potential fraud vulnerabilities across various processes.
• Formulate and implement comprehensive fraud prevention and detection strategies in the locations allocated and ensure the alignment of the same with the organizational targets of Allianz Partners.

2. Organization:

• Ensure to hire on time and position the right candidates (employees) at the right place to extend the fraud management coverage to all BUs in the Assistance (Roadside Assistance and the Home Assistance) space.
• Consult with Manager and the Leadership seeking support on the fulfilment and learn to economize and work to optimize the performance out of the team available.

3. Processes:

• Ensure that a properly documented, correct and a stepwise process of fraud referrals (from the assistance case handlers) is implemented and understood well on the operations floor.
• Ensure the execution of LoB wise Standard Operating Procedures (SOP) in each BU.
• Collaborate closely with other departments of Allianz Partners to integrate fraud prevention measures into daily operations.
• A rhythm is maintained to train all the new joiners in the BU and the GCC through a well document training material. The training material must be kept updated (on a need-to-know basis) with latest changes given the prevailing fraud trends.
• A regular and a periodic rhythm must be maintained in each BU and the GCC (in the regions allocated) to train the Assistance Case Handing team on the potential fraud red flags and the prevailing fraud trends. The training material must be kept updated with latest changes given the prevailing fraud trends.
• A separate fraud referral process and the SOP must be documented and implemented for the technology solution if used for fraud detection.
• In a situation where there is no technology solution available or the given business (claims) volumes in the BU do not merit a costly fraud detection solution, efforts must be undertaken to leverage the available internal systems and the means to create an alternative automated solution (e.g., the BU’s legacy system / One BI- Micro Strategy / SQL query-based reports etc.) to independently generate the fraud alerts basis the upfront business rules.
• Take the lead in the process of optimizing the business rules and the fraud red flags keeping in view the prevailing fraud trends- this is particularly important to augment the fraud detection and keeping a check on false positives, thus saving on productivity.
• Work to optimize the fraud funnel (fraud referrals or the fraud alerts) aligned to the local industry trends which help augment the fraud detection rate.
• Leverage the in-house Lead-Data Analytics in the Fraud Management COE Organization to identify the current and the emerging fraud patterns, anomalies and potential indicators of fraudulent activities and take timely remedial actions.
• Compliance: Ensure that fraud prevention practices align with industry regulations, legal requirements, and internal policies of Allianz Partners.
• Create Service Level Agreements (SLAs) on key KPIs (e.g., the TAT of triage and the fraud investigation, fraud referral rate, proven fraud rate etc.) and ensure adherence to the same.
• Monitor the performance through incisive KPIs. Ensure the execution of early warning signals (EWS) to catch frauds at an early stage.

4. Technology:

• Work with the Manager and Leadership to evaluate the implementation of a technology solution for the Assistance (especially the RSA) LoBs.
• Leads the execution of a technology solution for fraud detection.
• Efforts must be undertaken to leverage the available internal systems means to create an alternative automated solution (e.g., the BU’s legacy system / One BI- Micro Strategy / SQL query-based reports etc.) to independently generate the fraud alerts basis the upfront business rules.

5. People

• Ensure clear segregation of duties amongst the fraud management teams bases locally (in the BU), regionally (the GCC) and centrally (the Global Office). There must be clear definition of ‘Who does What’ at all locations and must be downloaded to one and all in the teams.
• A regular rhythm must be maintained to train all new joiners in the company (at the on-boarding stage), the Assistance Case Management team (especially the assistance case handlers) and the upskilling of the fraud management teams at the BUs and the GCCs.
• Must own the training of the fraud management teams in BUs and GCCs on the emerging fraud trends, the workable solutions.
• Periodically recognise the superior performance amongst the team and suitably reward them leveraging the company RnR (rewards & recognition) program.
• Must follow an operating rhythm to functionally review the performance of each BU and the GCC in the regions allocated through periodic townhalls, performance reviews, team meetings and the 1-0-1s.
• Must be able to motivate the team through effective team engagement and work to get the best out of them.

6. Reporting:

• Ensure, a proper operating rhythm is followed regularly to report the defined Fraud KPIs (refer to Group Standards), as required per the underlying process. A back-up to the first point of contact must be created to ensure timely reporting month on month without any delay.
• Work to automate (on best effort basis and to the extent possible) the reporting of KPIs (work with peers (Lead Data Analytics) in the Fraud Management COE organization to seek support in arriving at the solution centrally (for example, by way of leveraging the group standard, Micro Strategy).
• Ensure, the Fraud KPIs must be incisive and well thought out to rightly reflect the performance the BU, GCC and the overall LoBs (Assistance- Roadside and the Home) in the regions allocated.
• Ensure the publishing of the proper dashboards (standard template followed centrally) to stakeholders (internally in the function and to other departments on a need-to-know basis) on the performance of regions (Europe and Americas) allocated.

7. Other responsibilities:

• Incident Response: Lead and guide the investigation into the sensitive/high value suspected fraud cases in the locations, coordinating with law enforcement and legal teams, as necessary.
• Legal Collaboration: Collaborate with legal teams to ensure proper documentation and adherence to legal requirements in fraud-related matters, as necessary and as and when required.
• Vendor Management: Oversee relationships with external vendors (as applicable) providing fraud prevention services or technologies. Group policy and guidelines must be followed in terms of the due diligence and the overall criteria around the vendor selection.
• Team Leadership: Build and lead a high-performing team of operations professionals and foster a culture of innovation and excellence that improves AES (Allianz Engagement Survey) scores. Be an ambassador of AzP and role model our values while creating a high-performance culture and teams.
• Stakeholder management: Lead the activity of engaging the senior leadership and the stakeholders and ensure adequate visibility of the function / team through timely and appropriate communication to them. Be the voice of the function in the senior leadership forums.