Manager – Special Investigations Unit

West Bend Insurance Company•West Bend, WI

16h•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. Candidates who are located within 50 miles of our West Bend office location will work a hybrid schedule (at least 3 days/week) for collaboration days, team meetings or other in-person events.

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.