Senior Manager, SIU Fraud Investigation
Core
Developing, executing, and overseeing a comprehensive anti-fraud program driven by advanced data analytics to identify, investigate, and mitigate fraud, waste, and abuse across all lines of business.
Role type
Senior Manager, SIU Fraud Investigation
Builds
Enterprise anti-fraud program including intake, triage, investigation, recovery, and referral processes informed by advanced data analytics
Domain
Insurance / Healthcare / Anti-fraud
Deliverable
production ML models | dashboards & analysis | client delivery
Required skills
Advanced data analytics, project management, team leadership, policy development, stakeholder management, root-cause analysis, strategic planning, negotiation, independent decision-making, analytical judgment, confidential information management
Preferred skills
Certified Insurance Fraud Investigator (CIFI)
Technologies
Microsoft Windows, WORD, EXCEL, PowerPoint, Outlook
Responsibilities
Supervise detection, investigation, reporting, and mitigation of fraud, waste, and abuse; establish and oversee standards, policies, and procedural guidelines for the anti-fraud program; plan and direct development of advanced data analytics capabilities; lead and manage a team to drive performance and professional growth; serve as primary liaison with internal stakeholders, external partners, regulators, and law enforcement; conduct presentations and training for various groups
Seniority
Senior, hands-on IC with management responsibilities