Special Investigations Unit - HQ Operations Manager
About The Position
The Special Investigations Unit is seeking an SIU – HQ Operations Manager to supervise and oversee the unit’s headquarters operations functions. The role provides leadership for SIU analytics and lab functions, supports the development of analysts and lab forensic technicians, and manages regulatory compliance and state reporting. The manager works with SIU Field management and investigators to identify red-flag trends in claims data and provide actionable intelligence for investigations. The position also collaborates with PARM, Claims Operations, other internal groups, and external organizations on fraud detection and fraud-fighting initiatives. The role is expected to meet established service standards and develop new standards as needed.
Requirements
- Excellent verbal and written communication skills.
- Ability to identify and analyze key critical issues and provide solutions for successful outcomes.
- Ability to accomplish goals with minimal direct supervision and promote innovation.
- Ability to collaborate and invite feedback to initiate improvement.
- Astute listening skills and professional presentation skills.
- Data analysis experience.
- Proficiency with various databases and open-source intelligence.
- Proficiency with current PARM models and vendor tools used in SIU’s day-to-day operations.
- Four-year college degree or equivalent experience.
Responsibilities
- Provide leadership and direction for the SIU analytics function and SIU lab function.
- Support and identify development opportunities for SIU analysts and lab forensic technicians.
- Manage regulatory compliance and state reporting for the SIU function.
- Support and collaborate with SIU Field management and investigators, including identifying red-flag trends in claim data and providing actionable intelligence for SIU investigations.
- Collaborate with PARM, Claims Operations, and other internal groups on fraud detection models and technology.
- Work with external organizations such as NICB and the Coalition Against Insurance Fraud to support fraud-fighting initiatives.
- Meet established service standards and develop new standards as needed.
Benefits
- Eligible associates may receive an annual cash bonus and stock incentives based on company and individual performance.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
