Director, Fraud Prevention & Investigations - Remote - 2215972

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start

Caring. Connecting. Growing together.

Optum Financial’s industry-leading S3 payments platform is integrated at 60,000+ retail locations and supports some of the largest benefits and rewards programs in the world by offering value to consumers and directing the spending of funds to approved health-enhancing products and services. This advanced technology has led to Solutran’s rapid ascent to market leadership in healthcare benefits and has broader applicability across numerous other industries.

Working within a FinTech powerhouse, Optum Financial team members enjoy a culture of performance and collaboration, along with the resources and technology of a Fortune 5 company that comes with being a part of the UnitedHealth Group family of businesses. Our teams work in close partnership with the largest and most forward-thinking companies in America including Amazon, Uber, Humana General Mills, Kroger, UnitedHealthcare, Walmart, Walgreens and more.

A major component of our mission to create transformative healthcare payment experiences involves the ability to provide a seamless member experience at the point of sale. We are looking for an experienced fraud executive to drive our fraud and dispute operations strategy forward, establishing teams, frameworks and processes to drive detection, intervention and resolution, as well as ensure compliance with legal and cyber regulations.

You will be in the driver's seat and responsible for a team tasked with strengthening fraud prevention and investigation methodologies, establishing comprehensive transaction monitoring and performance reporting, and deploying comprehensive governance structures. In this role, you’ll partner with skilled counterparts across the organization to formulate, ideate, research, discover, and execute against the processes that enable the team to effectively grow and scale to support millions of members, billions in annual spend and over a dozen unique benefits nationwide.

The right candidate is someone who can “think big” while diving deep, remain flexible to change, and someone with a passion for innovation and operational excellence.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Partner with legal and compliance teams to establish and deploy a comprehensive fraud identification, management and prevention program, formalizing processes, tools, and resources to address fraud across a multi-billion dollar payments network

Establish a high-performing team to drive and support the operational roadmap for S3 and third-party network management

Lead the fraud prevention team, managing closely to key performance measures to effective investigation, prevention and analysis

Lead the organization in identifying and taking action against emerging fraud trends, working in partnership with security, legal and compliance teams to ensure processes meet and exceed industry standards

Conduct regular risk assessments, documenting areas of potential exposure areas across the platform and network, and holding cross-functional partners accountable to remediating and strengthening platform infrastructure

Manage vendor and partner relationships critical to identifying and addressing fraudulent activity

Advance predictive and AI-enabled fraud identification and scoring capabilities in partnership with Product and Analytics

Leverage best-in-class methodologies for problem resolution and real-time, continuous production monitoring, proactively addressing defects or network issues

Partner with client and retailer teams to navigate fraud issues, assessing impact to clients and internal stakeholders and supporting communication

Align and coordinate with core leaders and stakeholders across Product, Retail Operations, Network Engineering, Legal/Compliance and other key stakeholders to drive process and platform improvements that advance transaction decisioning integrity

Produce regular executive reporting for senior management

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

10+ years of experience in consumer fraud prevention, identification and investigation across financial services

5+ years of experience with NACHA, consumer card-related fraud, AML and OFAC regulatory frameworks

3+ years of experience in a people management/supervisory role

Preferred Qualifications:

Ability to influence, prioritize and execute improvement initiatives with a sense of urgency

Deep subject matter expertise in fraud trends, data analytics, fraud investigation

Experience establishing reporting, defining KPIs and ensuring adherence to SLAs

Comfort and experience with SQL analysis, Microsoft Office and other related tools

Excellent written communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only:

The salary range for this role is $122,100 to $234,700 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline:

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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