Claims Fraud Product Owner

Description

Lead the creation of a claims Special Investigation Unit platform that fuses predictive analytics, automation, and external intelligence to outpace fraud. Drive a roadmap that accelerates investigations, equips teams with real-time insights, and transforms how claims operations prevent and detect risk at scale. 

 

Why this role matters  

Drive the evolution of the Special Investigation Unit’s fraud prevention capabilities. In this role you will own the product backlog and roadmap for orchestrating advanced analytics, automation, and third-party data integrations that make investigators more effective and reduce loss. You’ll partner closely with engineering, data science, claims stakeholders, policy fraud, and claims fraud experience to turn models, data, and workflows into a scalable ecosystem that delivers demonstrable reductions in false positives, cycle time and low-yield investigative work. This is a high-impact role: your work will directly improve loss outcomes, operational efficiency, and compliance. 

 

Responsibilities  

• Own the SIU product backlog and roadmap for fraud prevention capabilities — including telematics, media forensics orchestration, policy-to-claims connectivity, and data-driven complex case management.

• Define capability strategy and APIs; collaborate with FraudX on the UI experience and co-author quarterly objectives and success metrics.

• Establish clear decision frameworks for prioritization (incorporating cost of delay, fraud risk severity, and resource tradeoffs) and make tradeoffs explicit to stakeholders.

• Deliver value quickly through “thin slice” releases that the the UI can easily surface to investigator workflows and prove impact early.

• Lead integration of external and internal data sources (e.g., NICB, Verisk, LexisNexis, telematics feeds, internal indicators) to improve quality and accelerate time-to-action.

• Drive outcome-focused measurements: contribution to loss accuracy, cycle-time reductions, precision of fraud indicators, investigator productivity, and compliance metrics.

• Embed “compliance by design”: ensure privacy, model governance, evidentiary standards, and regulatory requirements are considered throughout the product lifecycle.

• Partner with engineering, data science, operations, legal, policy fraud, and compliance to operationalize models, automate workflows, and maintain auditability.

• Communicate product vision, progress and tradeoffs to executive leadership and cross-functional teams. 

 

Ideal candidate will have  

• Domain knowledge of claims fraud, telematics, media forensics, or case management workflows — or a track record rapidly learning complex operational domains.

• Track record of delivering measurable outcomes (loss reduction, reduced cycle times, improved precision) from product initiatives.

• Experience partnering directly with agile teams to define capabilities needed and build API-driven platforms.

• Strong prioritization skills using frameworks such as cost of delay, risk severity, and ROI; ability to make and defend tradeoffs.

• Excellent stakeholder management and written/verbal communication skills; comfortable influencing senior leaders.

• Hands-on experience integrating third-party data providers (NICB, Verisk, LexisNexis, or similar) and understanding of data contracts and ingestion challenges.

• Familiarity with privacy requirements, model governance, and evidentiary standards relevant to investigations and regulated industries.  

 

Nice to have  

• Prior experience in insurance Special Investigations Units or enterprise fraud teams.

• Experience with investigator-facing tooling and workflow automation. 

 

What we offer 

• Opportunity to shape enterprise fraud strategy and a high-visibility role with measurable business impact.

• Cross-functional collaboration with engineering, claims, legal and compliance.

• Professional development and the ability to pilot modern, platform-oriented approaches to data, models and workflows.

• Competitive compensation, benefits, and a commitment to inclusive hiring and career growth. 

Qualifications

• Knowledge of Agile development methodologies and IT project management as typically acquired through a Bachelors` degree in relevant field (business, computer science, humanities, etc.) and a minimum of 2 to 4 years direct experience with agile teams as well as 5 years in business, technology or consulting.