Manager – Special Investigations Unit
About The Position
Lead the day-to-day operations of West Bend’s Special Investigations Unit (SIU), overseeing investigators and directing effective insurance fraud detection, investigation, and prevention. The manager handles complex, high-risk, high-exposure, and multi-jurisdictional cases, ensures investigations meet legal and regulatory standards, and works with internal teams and external agencies to prevent, detect, and resolve fraud. The role includes setting investigative standards, reviewing and approving critical actions and outcomes, developing SIU talent, and promoting fraud awareness across the organization. The manager also partners with law enforcement, fraud bureaus, industry organizations, Claims, Legal, Compliance, and Analytics teams; contributes to fraud analytics and reporting; tracks SIU performance; and manages vendors and investigative technologies. This position offers remote or hybrid work. Candidates living within 50 miles of the West Bend, Madison, or Appleton offices will work on a hybrid schedule. Fully remote employees who live farther away may occasionally travel to an office for team meetings, training, and corporate events.
Requirements
- At least 7 years of experience in insurance investigations, fraud detection, or SIU operations.
- At least 3 years of experience in a leadership role.
- Strong knowledge of property and casualty claims, fraud typologies, and investigative practices.
- Familiarity with fraud analytics tools, case management systems, and regulatory frameworks.
- Ability to manage complex investigations and make sound, defensible decisions.
- Proven ability to lead, develop, and inspire high-performing teams.
- Strong communication skills and ability to influence senior stakeholders.
- Bachelor’s degree in Criminal Justice, Business, Risk Management, Analytics, or a related field.
- At least one professional certification: CIFI, CFE, FCLS, or FCLA.
Nice To Haves
- Prior law enforcement experience.
- Multiple professional certifications.
- Insurance- or claims-related designations.
- Formal investigative or law enforcement training.
Responsibilities
- Oversee daily SIU operations and ensure consistent investigative standards and best practices.
- Guide investigators through complex, high-exposure, multi-jurisdictional, and organized fraud cases.
- Review and approve critical investigative actions, referrals, and outcomes.
- Lead SIU hiring, coaching, development, succession planning, and performance management.
- Mentor investigators and supervisors and foster accountability, growth, and excellence.
- Deliver investigative training and promote fraud awareness across the enterprise.
- Ensure investigations are thorough, defensible, and compliant with legal and regulatory requirements.
- Maintain adherence to state insurance fraud statutes, reporting obligations, and regulatory expectations.
- Support audits, regulatory examinations, and external inquiries related to SIU operations.
- Serve as a liaison with law enforcement, fraud bureaus, and industry organizations.
- Partner with Claims, Legal, Compliance, and Analytics teams to strengthen fraud detection and prevention strategies.
- Contribute to fraud analytics initiatives, tools, and reporting enhancements.
- Monitor SIU metrics, including referrals, cycle times, and outcomes, to identify trends and opportunities.
- Manage vendor relationships and investigative technologies to optimize performance.
- Lead initiatives to improve fraud prevention and operational effectiveness.
Benefits
- Medical and prescription insurance
- Health Savings Account
- Dental insurance
- Vision insurance
- Short- and long-term disability
- Flexible Spending Accounts
- Life and Accidental Death & Disability insurance
- Accident and Critical Illness insurance
- Employee Assistance Program
- 401(k) plan with company match
- Pet insurance
- Paid Time Off; standard first-year PTO is 17 days, prorated based on month of hire, with enhanced PTO potentially available for experienced candidates
- Performance-based bonus eligibility
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What This Job Offers
Job Type
Full-time
Career Level
Manager
