I was responsible for leading cross functional and dedicated teams that built software products for internal use at American Family Insurance using agile methodologies. I led a team that built a claims fraud detection solution that increased fraud referral volume and also increased referral quality. I built the strategy for what the product would be and the creation of the roadmap of when the team would be able to produce. I was able to motivate the team to build the solution and get it into production quickly so we could end our contract with a vendor and avoid an extra $300,000 license fee. I was able to have the fraud referrals flow into a new case management system to increase the efficiency of the SIU triage rep by them not having to use multiple systems to process the referral. I built the strategy and led a development team on the identification of Agency fraud. I communicated with stakeholders on the importance of prioritizing the most common known fraud indicators and not try to discover one off frauds. I led the team on creation of a dashboard that identified the most common known fraud indicators and combined that with a scoring mechanism to prioritize which agencies should be investigated. The result of the first dashboard run was the identification of about a dozen agencies that should be investigated.

I was responsible for all automated claim fraud detection for American Family Insurance. I maintained the relationship with our vendor on the efficiency of their fraud detection solution that we used. I led a staff of Analysts and Triage reps that reviewed the output of the detection system and opened cases for investigators. I onboarded a new case management system and built workflows SIU Triage reps for opening a referral and assigning it to an Investigator and a workflow for the Investigators to work a case to completion while capturing data needed for metrics. This led to an increase in efficiency and more accurate metrics. I was responsible for leading a team that shared all SIU metrics and reporting.

I was responsible for leading a staff of remote employees that investigated potential claim fraud in 2 states. I perform audits to make sure the quality of the investigations being performed were in line with company standards and provided our claim adjusters the information they needed to make accurate claim decisions in a timely manner. I was responsible for the relationship with the claim offices in the states I supervised. I provided the offices with their fraud fighting metrics as well as information on trends from the fraud industry. I was also in charge of the relationship with the vendor we used for our automated fraud detection system. I met with the vendor regularly on performance of the solution as well as updates on any imporvements.