Senior SIU Manager: Fraud Investigations Leader

The Silver Lining; Idaho; Hybrid; USD 110,000 - 150,000; Full time

Benefits offered by this job

Medical & Prescription Insurance

Health Savings Account

Dental Insurance

Vision Insurance

Disability Insurance

Flexible Spending Accounts

Life and AD&D Insurance

Paid Time Off

Bonus eligible

Job summary

West Bend in Wisconsin seeks a strategic, hands-on SIU Manager to lead a high-impact team focused on detecting and preventing insurance fraud. You will guide investigators through complex cases, shape SIU strategy, and collaborate with Claims, Legal, Compliance, and Analytics to strengthen enterprise-wide fraud prevention.

The role emphasizes regulatory compliance, multi‑jurisdictional investigations, and leadership of a diverse team. Remote/hybrid options available with travel as needed.

Qualifications

• 7+ years in insurance investigations, fraud detection, or SIU operations.
• 3+ years in a leadership role.
• Bachelor’s degree in Criminal Justice, Business, Risk Management, Analytics, or related field.
• At least one professional certification required (CIFI, CFE, FCLS, FCLA).
• Insurance or claims-related designations are a plus

Responsibilities

• Oversee the day-to-day operations of the SIU, ensuring consistent investigative standards and best practices.
• Guide investigators through complex, high-exposure, multi-jurisdictional fraud cases.
• 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 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.

Skills

Fraud investigations

Leadership

Stakeholder collaboration

Regulatory compliance

Team development

Education

Bachelor's degree in Criminal Justice or related field

Professional certifications (CIFI, CFE, FCLS, FCLA)

Tools

Fraud analytics tools

Case management systems

Job description

West Bend in Wisconsin seeks a strategic, hands-on SIU Manager to lead a high-impact team focused on detecting and preventing insurance fraud. You will guide investigators through complex cases, shape SIU strategy, and collaborate with Claims, Legal, Compliance, and Analytics to strengthen enterprise-wide fraud prevention.

The role emphasizes regulatory compliance, multi‑jurisdictional investigations, and leadership of a diverse team. Remote/hybrid options available with travel as needed.