Senior SIU Operations Lead (Interim) – Process & Compliance

RGP; Los Angeles (CA); On-site; USD 140,000 - 190,000; Full time

Job summary

RGP is seeking a highly experienced Senior Operations Manager to lead the Special Investigations Unit (SIU) and optimize cross-functional workflows in a temporary capacity. The role focuses on improving efficiency, standardizing processes, and ensuring regulatory compliance across investigations, audits, and related activities.

The ideal candidate brings healthcare compliance and investigative operations expertise, with a proven track record in driving measurable process improvements and strong

Qualifications

• Bachelor's degree required; advanced degree or certifications such as CFE, AHFI, CHC, or equivalent preferred.
• 7+ years of progressive leadership experience in healthcare compliance, SIU, fraud, waste and abuse (FWA), investigations, audit, or health plan operations.
• Demonstrated success leading operational improvement initiatives and implementing sustainable business processes.
• Strong understanding of managed care operations, healthcare regulations, CMS requirements, and FWA programs.
• Proven ability to evaluate workflows, identify gaps, and implement process improvements that drive measurable results.
• Excellent analytical, organizational, and problem-solving skills.
• Strong leadership, communication, and stakeholder management capabilities.

Responsibilities

• Provide operational leadership and oversight for SIU programs, processes, and day-to-day activities.
• Drive consistency, efficiency, and quality across investigative, audit, and compliance-related workflows.
• Assess current operational processes and identify opportunities for standardization, optimization, and continuous improvement.
• Develop and implement process enhancements that improve productivity, turnaround times, and overall team effectiveness.
• Serve as a resource for complex operational questions, escalations, and process-related challenges.
• Monitor performance metrics, operational trends, and key deliverables to support informed decision-making.
• Ensure adherence to regulatory requirements, internal policies, documentation standards, and compliance expectations.
• Partner with internal stakeholders across Compliance, Audit, Legal, Medical Management, and Operations to support program objectives.
• Create and maintain operational workflows, SOPs, and best practices.
• Provide regular updates, recommendations, and strategic insights to senior leadership regarding operational performance and improvement opportunities.
• Support change management initiatives and promote adoption of enhanced business processes.

Skills

Analytical skills

Organizational skills

Problem-solving

Leadership

Communication

Stakeholder management

Interim leadership

Education

Bachelor's degree

Advanced degree or certifications (CFE AHFI CHC)

Job description

RGP is seeking a highly experienced Senior Operations Manager to lead the Special Investigations Unit (SIU) and optimize cross-functional workflows in a temporary capacity. The role focuses on improving efficiency, standardizing processes, and ensuring regulatory compliance across investigations, audits, and related activities.

The ideal candidate brings healthcare compliance and investigative operations expertise, with a proven track record in driving measurable process improvements and strong