SIU Director

Jobtailor; California (MO); On-site; USD 120,000 - 190,000; Full time

Job summary

Jobtailor is seeking a senior leader to head the fraud investigations unit, overseeing operations, budgets, and vendor relationships. You will guide internal teams and external providers to maximize performance and ensure policy compliance.

The ideal candidate brings 10+ years in fraud investigations within insurance or related fields, plus advanced knowledge of underwriting and claims handling, and strong leadership and communication skills.

Qualifications

• Bachelor's degree or equivalent professional experience.
• Professional certification related to fraud investigations preferred (CFE, CIFI, FCLS, FCLA).
• Minimum of ten (10) years of experience conducting or directing investigations in insurance fraud or related fields.
• Experience managing or supervising others preferred.
• Ability to lead and develop a multi-layer investigations group and manage external service providers.
• Advanced claims investigations and resolution skills.
• Advanced knowledge of underwriting, claims handling principles, and insurance operations.

Responsibilities

• Lead operational, budgetary, and financial activities of the fraud investigations unit.
• Direct internal resources and external service providers to maximize unit performance.
• Participate in strategic and operational initiatives aligned to goals.
• Negotiate, monitor, and evaluate vendor performance per policies and contracts.
• Identify trends and opportunities using resources, tools, and metrics.
• Manage staff by attracting talent, setting direction, providing guidance, managing performance, recognizing contributions, and developing capabilities.
• Maintain transparent communication through department meetings, one-on-one meetings, email, and interpersonal communication.
• Establish and oversee best practices and ensure training development and delivery.
• Maintain and share current industry knowledge regarding law, trends, and issues.
• Represent the company at industry associations and insurance fraud or related industry events.
• Participate in special projects, including investigations or surveillance on high-complexity matters.

Skills

Fraud investigations leadership

Advanced claims investigations

Insurance operations knowledge

Leadership and team development

Vendor management

Communication and negotiation

Analytical problem solving

Microsoft Office

Education

Bachelor's degree

CFE

CIFI

FCLS

FCLA

Tools

Microsoft Office Suite

Business Software

Job description

• Lead overall operational, budgetary, and financial activities of the fraud investigations unit
• Direct internal resources and external service providers to maximize unit performance
• Participate in strategic and operational initiatives based on departmental and corporate goals
• Negotiate, monitor, and evaluate vendor performance and ensure compliance with policies, contracts, fiduciary guidelines, and service agreements
• Identify trends and improvement opportunities using resources, tools, and metrics
• Manage staff by attracting talent, setting direction, providing guidance, managing performance, recognizing contributions, and developing capabilities
• Maintain transparent communication through department meetings, one-on-one meetings, email, and interpersonal communication
• Establish and oversee best practices and ensure training development and delivery
• Maintain and share current industry knowledge regarding law, trends, and issues
• Represent the company at industry associations and insurance fraud or related industry events
• Participate in special projects, including investigations or surveillance on high-complexity matters

Requirements

• Bachelor's degree or equivalent professional experience
• Professional certification or designation related to fraud investigations strongly preferred (e.g., CFE, CIFI, FCLS, FCLA, or similar)
• Minimum of ten (10) years of experience conducting or directing investigations in insurance fraud, law enforcement, civil or criminal litigation, or a similar field
• Experience managing or supervising others preferred
• Ability to lead, coach and develop a multi-layer investigations group and manage external service providers
• Advanced claims investigations and resolution skills
• Advanced knowledge of insurance and claims handling principles, practices, and procedures
• Advanced underwriting investigation and risk assessment skills
• Advanced knowledge of underwriting principles, practices, procedures, and insurance operations
• Excellent communication, negotiation, and presentation skills
• Excellent analytical and problem solving skills
• Proficiency with Microsoft Office Suite and business software
• Ability to manage multiple projects and teams
• Ability to deal effectively with ambiguous situations and issues

Core Competencies

Demonstrates advanced knowledge of insurance and claims handling principles, along with strong leadership capabilities to manage investigations teams and external service providers. Proficient in negotiation, communication, and analytical problem-solving to drive operational excellence in fraud investigations.

Highest-signal resume keywords

• Fraud Investigations Management
• Advanced Claims Investigations
• Insurance Operations Knowledge
• Professional Certification (CFE, CIFI, FCLS, FCLA)
• Leadership and Team Development

ATS Optimization Keywords

Hard Skills

• Advanced Claims Investigations
• Underwriting Investigation Skills
• Risk Assessment Skills
• Insurance Principles Knowledge
• Analytical Problem Solving

Soft Skills

• Excellent Communication
• Negotiation Skills
• Presentation Skills
• Coaching and Development

Certifications & Qualifications

• CFE
• CIFI
• FCLS
• FCLA

Industry Keywords

• Fraud Investigations
• Insurance Fraud
• Compliance
• Vendor Performance Evaluation
• Operational Initiatives

Tools & Technologies

• Microsoft Office Suite
• Business Software