Fraud & Claims Call Monitoring Lead

Description

Primary responsibilities include

Core Qualifications & Skills

• Advanced understanding of QC methodologies, controls, and business processes
• Strong analytical skills with the ability to interpret trends and drive business insights
• Demonstrated leadership capability without direct authority (influence-based leadership)
• Experience leading meetings, presentations, and cross-functional discussions independently
• Strong communication skills (written and verbal), especially in translating data into business impact
• Proven ability to manage competing priorities and drive outcomes

• Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms)

Functional Leadership

• Operates independently, presenting findings, insights, and recommendations with minimal leadership support
• Serves as a subject matter leader in meetings, reviews, and cross-functional engagements
• Ensures consistency, accuracy, and alignment in QC practices and outputs

Business & Strategic Impact

• Champions corporate and business-line initiatives impacting QC, including AI and process modernization
• Leads Business Line Reviews (BLRs) and stakeholder meetings independently
• Drives closed-loop resolution of identified issues impacting customers or business outcomes
• Translates QC findings into actionable insights that influence business decisions

Team Leadership & Development

• Develops and delivers training plans and materials for new and existing colleagues
• Supports hiring and onboarding activities (e.g., interviews, access setup coordination)
• Acts as a primary escalation point and buffer between team members (S3, S4, P1) and leadership
• Conducts spot checks and peer reviews to ensure quality and consistency
• Coaches team members using findings to improve performance and capability
• Owns performance management administrative activities, including tracking key metrics
• Leads by example, reinforcing professionalism, accountability, and positive team behaviors

Problem Solving & Decision Support

• Identifies trends, themes, and complex issues across QC results
• Performs fact-based analysis to develop and recommend solutions to leadership
• Ensures issues are fully resolved, not just documented
• Leads decision support efforts for escalations, exceptions, and disputes
• Provides input into business decisions related to corrective actions and risk mitigation

Operational Impact

• Drives team outcomes and ensures timely completion of work across all levels (S3, S4, P1)
• Maintains limited individual QC workload, focusing primarily on leadership and oversight responsibilities
• Leads walkthroughs and supports audits, risk reviews, and GenAI-related initiatives
• Ensures readiness for internal and external audits through strong documentation and execution

Interpersonal & Influence Skills

• Models strong professionalism, sound judgment, and collaboration
• Builds trust as a reliable escalation and advisory resource
• Effectively navigates sensitive or complex conversations with business partners and stakeholders
• Acts as a bridge between QC teams and leadership, ensuring clarity and alignment

Qualifications, Education, Certifications and/or Other Professional Credentials

• Required Qualifications
  • 1-2 years experience in Fraud or Claims operations or; 1-2 years of QC experience within a financial services environment
  • Advanced understanding of QC methodologies, controls, and business processes
  • Strong analytical skills with the ability to interpret trends and drive business insights
  • Demonstrated leadership capability without direct authority (influence-based leadership)
  • Experience leading meetings, presentations, and cross-functional discussions independently
  • Strong communication skills (written and verbal), especially in translating data into business impact
  • Proven ability to manage competing priorities and drive outcomes

  • Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms)

Hours & Work Schedule

• Hours per Week: 40
• Work Schedule: Hybrid 4 Days in Office - Monday- Friday 8:00am-5:00pm

Some job boards have started using jobseeker-reported data to estimate salary ranges for roles. If you apply and qualify for this role, a recruiter will discuss accurate pay guidance.

Equal Employment Opportunity

Citizens, its parent, subsidiaries, and related companies (Citizens) provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, ancestry, color, citizenship, physical or mental disability, perceived disability or history or record of a disability, ethnicity, gender, gender identity or expression, genetic information, genetic characteristic, marital or domestic partner status, victim of domestic violence, family status/parenthood, medical condition, military or veteran status, national origin, pregnancy/childbirth/lactation, colleague’s or a dependent’s reproductive health decision making, race, religion, sex, sexual orientation, or any other category protected by federal, state and/or local laws. At Citizens, we are committed to fostering an inclusive culture that enables all colleagues to bring their best selves to work every day and everyone is expected to be treated with respect and professionalism. Employment decisions are based solely on merit, qualifications, performance and capability.