Manager - Special Investigations Unit

West Bend Mutual Insurance Company; United States; A distancia; USD 110.000 - 150.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical Insurance

Prescription Coverage

HSA

Dental Insurance

Vision Insurance

Disability Insurance

FSAs

Life & AD&D

Critical Illness

EAP

401(k) Match

Pet Insurance

PTO

Bonus eligible

Descripción de la vacante

West Bend Mutual Insurance Company is seeking a Manager to lead the Special Investigations Unit. The role directs investigators, drives fraud detection and investigations, and partners across Claims, Legal, Compliance, and Analytics to strengthen prevention strategies.

You will oversee complex cases, maintain regulatory alignment, and shape SIU strategy while mentoring a high-performing team in a remote/hybrid setting.

Formación

• Bachelor's degree in Criminal Justice, Business, Risk Management, Analytics, or related field.
• At least 7 years in insurance investigations or SIU operations with 3+ years in leadership.
• Certifications such as CIFI, CFE, FCLS or FCLA are preferred.

Responsabilidades

• Lead the SIU operations and oversee investigators to detect and prevent fraud.
• Guide complex, high-exposure, cross-jurisdictional cases and ensure defensible findings.
• Ensure regulatory compliance and coordinate with law enforcement and analytics teams.
• Develop talent, mentor staff, and deliver investigative training.

Conocimientos

Investigations leadership

Fraud detection

Regulatory knowledge

Team leadership

Communication

Educación

Bachelor's degree in Criminal Justice, Business, Risk Management, Analytics, or related field

Herramientas

Fraud analytics tools

Case management systems

Descripción del empleo

Manager - Special Investigations Unit

Job Locations

US-Remote

ID 2026-3958

Category: Claims

Full-Time

Remote/Hybrid: Remote

Company Overview

Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

Job Summary

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.

Work Location

This position offers both remote and hybrid work locations. Candidates who reside within 50 miles of an office location (West Bend, Madison, Appleton) will be offered a hybrid work schedule. Candidates who are fully remote (beyond 50 miles) may occasionally be asked to travel to an office location for in-person engagement activities such as team meetings, training and corporate events.

Responsibilities & Qualifications

Lead the Fight Against Fraud - SIU Manager

Are you ready to take on complex fraud challenges and lead a high-impact team at the forefront of insurance integrity? We're looking for a strategic, hands-on Special Investigations Unit (SIU) Manager to drive excellence in fraud detection, investigation, and prevention.

In this role, you won't just manage operations-you'll shape how fraud is identified, investigated, and resolved across the organization. You'll lead a team of skilled investigators, partner with cross-functional stakeholders, and play a key role in protecting our business and customers from evolving fraud risks.

What You’ll Do:

Lead & Elevate SIU Operations

• 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.

Build & Develop High-Performing Teams

• 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 Compliance & Integrity

• 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.

Collaborate & Influence

• 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.

Drive Insights & Performance

• 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.

What You Bring:

• Experience:
  • 7+ years in insurance investigations, fraud detection, or SIU operations
  • 3+ years in a leadership role
  • Prior law enforcement experience is a plus
• Expertise:
  • 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
• Leadership:
  • Proven ability to lead, develop, and inspire high-performing teams
  • Strong communication skills with the ability to influence senior stakeholders

Education & Certifications:

• Bachelor's degree in Criminal Justice, Business, Risk Management, Analytics, or related field
• At least one professional certification required (CIFI, CFE, FCLS, FCLA), with multiple certifications preferred
• Insurance or claims-related designations are a plus
• Formal investigative or law enforcement training nice to have

Why This Role Matters:

Fraud is constantly evolving-and so are we. In this role, you'll have the opportunity to shape strategy, influence enterprise-wide decisions, and make a measurable impact. Your leadership will directly strengthen our ability to detect fraud, protect our customers, and uphold trust.

#LI-BW1

Salary Statement

The salary range for this position is $110,000-$150,000.

The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate.

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
• West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies.

EEO

West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.