Fraud & Claims Operations Manager Job at Wells Fargo (Chandler)

Fraud & Claims Operations Director

Wells Fargo is seeking a Fraud & Claims Operations Director. We believe in the p...

Location

Philippines , Taguig City

Salary:

Not provided

Wells Fargo

Expiration Date

June 29, 2026

Requirements

10+ years of fraud claim investigations or policy violations, risk management, or compliance experience, or equivalent experience demonstrated through one or a combination of the following: work experience, training, military experience, education
6+ years management experience

Job Responsibility

Provide vision and set direction for execution and management of a risk based fraud and claims program across the enterprise with significant risk and complex regulatory environments in order to achieve long term strategic objectives that impact the organization and management across functions
Collaborate with cross channel business leaders, as well as legal, audit, and multiple US or non US regulators to develop highly complex strategies and goals
Provide thought leadership to develop and implement strategic solutions to highly complex and potentially enterprise wide business risks or challenges
Lead a team of experienced business leaders and develop risk policies, procedures, and controls for fraud and claims business area in order to achieve business objectives
Collaborate with and influence cross channel business leaders, external community members, including regulators or auditors, law enforcement, elected officials and trade groups
Lead and oversee fraud claims investigations and policy violation reviews, ensuring timely, accurate, and compliant case resolution
Provide day‑to‑day management and coaching to investigation or risk teams, driving consistent execution, quality standards, and employee development
Ensure adherence to enterprise policies, regulatory requirements, and internal control standards, escalating material risks and issues as appropriate
Review complex, high‑impact, or sensitive cases, applying strong risk judgment and investigative rigor
Identify trends, root causes, and control gaps

Fulltime

Vice President - Fraud Operations Claims & Investigations

The Vice President - Fraud Operations Claims & Investigations will lead the end-...

Location

United States , Henderson

Salary:

130000.00 - 185000.00 USD / Year

Barclays

Expiration Date

Until further notice

Requirements

Deep expertise in financial services operations, including credit card fraud, disputes, and chargeback management
Proven ability to lead large-scale, high-volume operations and manage multiple layers of leadership, including front-line managers and Assistant Vice Presidents
Demonstrated success in driving operational transformation, implementing process improvements, and enhancing control frameworks

Job Responsibility

Identification of trends and opportunities to improve areas and develop new process and procedures through the monitoring and analysis of operation data and performance metrices
Management of operations for a business area and promote efficient processes, risk management and compliance initiatives to support the bank's operations
Collaboration with internal stakeholders (including business leaders, project manager and SMEs) and external stakeholders (including vendors and service providers) to support business operations and promote alignment with the bank's objectives and SLAs
Management of operational professionals and provide guidance, coaching and support to improve colleagues' delivery quality
Management and development of KPIs to measure the effectiveness of operation functions, utilising data and technology to support the identification of areas that require improvement
Compliance with all regulatory requirements and internal policies related to customer experience
Creation of a safe environment for colleagues to speak up, actively and regularly encourage and solicit feedback to ensure people agenda remains focused on the right areas
Management of attrition by working closely with HR in implementing retention initiatives for work force

What we offer

Hybrid working
Modern workspaces, collaborative areas, and state-of-the-art meeting rooms
Facilities include wellness rooms, on-site cafeterias, fitness centers, and tech-equipped workstations
Health and wellness
A place where you can belong

Fulltime

Claims Technical Operations Manager (Pet)

We're looking for a new Claims Technical Operations Manager to become a part of ...

Location

Salary:

Not provided

Admiral Group Plc

Expiration Date

Until further notice

Requirements

Proven success in delivering effective Technical claims leadership within a financial services organisation
A skilled communicator who is articulate and compelling, with the ability to effectively communicate at all levels with a range of internal and external stakeholders
Capability to appropriately and effectively raise issues, risks, and challenges
Highly developed leadership skills with experience engaging large teams
Ability to work with a high degree of autonomy
Excellent organisational and proficient analytical skills
Experienced commercial leader with a solid understanding of key aspects such as operational expenditure
Strong IT skills and competence in using the MS Office suite of products

Job Responsibility

Lead and develop our specialised Technical Claims function within a busy Claims Operation, including responsibilities for areas such as Counter-Fraud, Recoveries, and Liability activities
Collaborate with cross-functional teams (both internal and external) to seamlessly align and deliver business priorities
Propose, create, and manage the Pet Claims indemnity strategy, ensuring ongoing awareness and alignment of the strategic roadmap for the wider Pet business while delivering strong governance controls and frameworks in accordance with risk appetite
Ensure relevant processes and procedures are established to facilitate the effective delivery of our strategic business initiatives and consistently applied across all claims activities
Lead and support colleagues and teams to embrace and develop high technical capabilities, fostering deep subject-matter expertise and a strong technical culture
Monitor performance through regular MI analysis, initiating and implementing continuous improvements to maximise departmental performance
Participate in product and service reviews to suggest relevant changes
Conduct and document 'Lessons Learned' activities for key Technical workstreams
Stay actively informed about industry news, changes, and trends, translating insights into practical actions
Encourage continuous improvement in technical knowledge, decision-making, and customer outcomes

What we offer

Up to £3,600 of free shares each year after one year of service
33 days holiday (including bank holidays) when you join us, increasing to a maximum of 38 days
Option to buy or sell up to an additional five days of annual leave

Fulltime

Fraud Operations Senior Professional

In this role at Citizens, you’re made ready for a fulfilling career with excitin...

Location

United States , Johnston; Pittsburgh; Irving

Salary:

Not provided

Citizens Bank

Expiration Date

Until further notice

Requirements

8+ years fraud prevention or fraud risk management experience working in the financial services industry
Deep understanding of bank products and operations
current fraud prevention and detection techniques
and key processes, controls, and exposure areas
Effective influencing and conflict resolution skills
Strong problem solving and analytical skills, attention to detail, and the ability to work independently and as part of a team
Excellent communication skills (oral and written), interpersonal / business partnering, and organizational skills
Bachelor’s degree in relevant field required
Certified Fraud Examiner, Certified Internal Auditor, Certified Public Accountant and/or Risk Management certifications preferred

Job Responsibility

Oversee fraud prevention activities for assigned enterprise-level business units
Provide guidance on fraud policies, standards, processes, and tools
Conduct, where appropriate, fraud risk assessments
Act as a fraud prevention subject matter expert to ensure projects, programs, processes, and product initiatives align with fraud policies and standards
Challenge and advise on new products or services, issues, key fraud risk indicators, and vendor engagements
Assist business unit managers in establishing a proactive fraud prevention posture, led by evolving data-driven intelligence and solutions, to ensure losses remain within risk appetites
Review and analyze fraud cases to identify trends and mitigation opportunities
Partner with Fraud and Claims colleagues and Corporate Security and Resilience to ensure the results and learnings from fraud incidents and investigations are effectively leveraged to prevent future fraud incidents
Identify emerging fraud prevention risks and control issues in the operating environment, while working with the business line to implement action plans to mitigate business impact
Collaborate with business lines to ensure appropriate alerting mechanisms and effective requirements for proper authentication are implemented

What we offer

competitive pay
comprehensive medical, dental and vision coverage
retirement benefits
maternity/paternity leave
flexible work arrangements
education reimbursement
wellness programs

Fulltime

Manager, Utilization Management Claims Review

The Manager, Utilization Management Claims Review is responsible for overseeing ...

Location

United States , Los Angeles

Salary:

117509.00 - 188015.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Nursing
In lieu of degree, equivalent education and/or experience may be considered
At least 6 years of experience in Clinical Nursing
At least 3 years of experience with Medi-Cal and Medicare in a managed care environment
At least 4 years of leading staff, supervisor/management experience
Experience in performing and creating clinical documentation
Experience in regulatory compliance for a health plan
Experience leading teams, projects, initiatives, or cross-functional groups
Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement
Registered Nurse (RN) - Active, current and unrestricted California License

Job Responsibility

Manage staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others
Ensure quality standards are met by regularly reviewing claim files, clinical decisions, and Provider Dispute Review (PDR) determinations to confirm compliance with company policies, clinical guidelines, and regulatory requirements
Identify trends or errors and implement improvements to increase accuracy and consistency
Establish team goals, monitor performance metrics, and ensure productivity and quality standards are met
Support recovery efforts and corrective action plans related to inappropriate billing or utilization patterns
Oversee workflow and queue management to ensure claims and PDR requests are completed within required regulatory timeframes, including monitoring workload distribution
Ensure adequate staffing resources and prevent backlogs or compliance risks
Ensure clinical policies are applied correctly and consistently, including policies designed to prevent fraud, waste, and abuse (FWA)
Potential FWA concerns are identified and escalated in partnership with Compliance and the Special Investigations Unit (SIU)
Support audits, regulatory readiness, and cross-functional initiatives to maintain compliance with state, federal, and accreditation standards

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

New

Senior Lead Artificial Intelligence Solutions Consultant

Wells Fargo is seeking a visionary and execution-focused Senior Lead Digital Pro...

Location

United States , Charlotte; Irving

Salary:

Not provided

Wells Fargo

Expiration Date

June 25, 2026

Requirements

7+ years of digital product management experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education

Job Responsibility

Execute O2A lifecycle activities (Observe → Optimize → Analyze → Run)
Support configuration of Observe Assistant, activity tagging, persona behavior modeling
Work with engineering to translate observed behavior into actionable agentic features
Define enterprise strategy for O2A observation, optimization, and agent generation
Build O2A operating model including governance, lifecycle stages, roles/responsibilities, and prioritization framework
Determine scalable implementation pathways for persona coverage, behavioral insights, and continuous optimization loops
Define strategic roadmap for enterprise Agentic AI adoption (autonomous workflows, memory, planning, tool‑use architectures)
Partner with AI, IA, Data, Operations and Technology leaders to align multi‑year roadmap
Develop business cases for large‑scale agent deployment derived from observed tasks
Govern intake, prioritization, and sequencing across businesses and functions

Fulltime

New

Security Officer

Summary: The Security Officer will be responsible for promoting a safe environme...

Location

United States , Richmond

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

Knowledge of CCTV operations preferred
CPR and First Aid certified or willingness to be certified once hired
Basic computer skills of the Microsoft Office Suite
Fluent in English (spoken and written)
Bilingual in English and Spanish preferred
Ability to create a legible activity/incident/investigative report
Capable of communicating with tact and professionalism
This role does not require security certification

Job Responsibility

Report and documents any unsafe working practices or conditions, and recommend corrective action
Monitor, document, and report suspicious activity observed on security cameras
Identify visitors at associate entrance, issue and collect passes in accordance with procedures
Control and account for all keys, especially keys to critical areas
Conduct investigations of all incidents of theft, fraud, violence, property damage, personal injury, unlawful entry, trespassing and any other event that creates a disturbance on the premises or which may result in a claim against the organization. Create a detailed written report of your investigation
Observe persons on premises who abuse hotel facilities, intrude into restricted areas, disturb or intrude upon the privacy of guests. Initiate action to remove such individual(s) from the premises
Thorough knowledge of hotel's emergency fire, bomb threat, first aid, and tornado procedures and evacuation plan
Maintain a detailed log book and activity sheet entries
Log in items and secure items for lost and found
Generate associate identification cards

What we offer

Medical
Dental
Vision
Paid Parental Leave
Life Insurance
Employee Assistance Program (EAP)
401(k)
Vacation and Paid Time Off (PTO)
Tuition Reimbursement
Complimentary and Discounted Rooms

Fulltime

New

Fraud Specialist

We are seeking a detail-oriented and analytical Fraud Specialist to join our tea...

Location

United States , Rochester

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Detail-oriented and analytical
strong investigative skills
sound judgment
ability to handle sensitive information with professionalism and confidentiality
background in criminal justice strongly preferred

Job Responsibility

Monitor accounts, transactions, applications, or claims for suspicious or potentially fraudulent activity
Investigate fraud alerts, exceptions, and high-risk cases in a timely manner
Review documentation, account history, patterns, and supporting data to determine risk and next steps
Conduct outbound calls or written follow-up to verify activity and gather additional information
Document investigations clearly and accurately in internal systems
Escalate confirmed or suspected fraud cases according to company procedures
Partner with internal departments such as operations, compliance, customer service, risk, and management to resolve issues
Assist with fraud prevention efforts, trend tracking, and reporting
Maintain confidentiality and ensure compliance with internal policies and applicable regulations
Recommend process improvements to strengthen fraud detection and prevention controls

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan

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Fraud & Claims Operations Manager

Job Description

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