Manager – Special Investigations Unit

West Bend Insurance Company • West Bend, WI

1d • Hybrid

About The Position

Lead the day-to-day operations of a Special Investigations Unit, overseeing investigators and driving effective fraud detection and investigation efforts. This role manages complex and high-risk cases, ensures compliance with legal and regulatory standards, and partners with internal teams and external agencies to prevent, detect, and resolve insurance fraud.

Requirements

• 7+ years in insurance investigations, fraud detection, or SIU operations
• 3+ years in a leadership role
• Strong knowledge of P&C 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 with the ability to influence senior stakeholders
• Bachelor’s degree in Criminal Justice, Business, Risk Management, Analytics, or related field
• At least one professional certification required (CIFI, CFE, FCLS, FCLA)

Nice To Haves

• Prior law enforcement experience is a plus
• Multiple certifications preferred
• Insurance or claims-related designations are a plus
• Formal investigative or law enforcement training nice to have

Responsibilities

• Oversee the day-to-day operations of the SIU, ensuring consistent investigative standards and best practices.
• Guide investigators through complex, high-exposure, and multi-jurisdictional fraud cases, including organized fraud activity.
• Review and approve critical investigative actions, referrals, and outcomes.
• Own the SIU talent strategy: hiring, coaching, development, succession planning, and performance management.
• Mentor investigators and supervisors, fostering a culture of accountability, growth, and excellence.
• Deliver investigative training and promote fraud awareness across the enterprise.
• Ensure all 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 exams, and external inquiries related to SIU operations.
• Serve as a key 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 such as referrals, cycle times, and outcomes to identify trends and opportunities.
• Manage vendor relationships and investigative technologies to optimize performance.
• Lead initiatives that enhance fraud prevention and operational effectiveness.

Benefits

• Medical & Prescription Insurance
• Health Savings Account
• Dental Insurance
• Vision Insurance
• Short and Long Term Disability
• Flexible Spending Accounts
• Life and Accidental Death & Disability
• 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, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates
• Bonus eligible based on performance

What This Job Offers

• Job Type: Full-time
• Career Level: Manager