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SIU Manager

The SIU Manager is responsible for assisting with leading our anti-fraud efforts to include both commercial and personal lines of business. This role is critical in safeguarding the integrity of our claims process, mitigating financial losses, and ensuring compliance with regulatory mandates. The SIU Manager will be responsible for overseeing a team of investigators and support specialists, managing complex and high-exposure investigations, and assisting with investigative tools to support the enterprise anti-fraud efforts.

Responsibilities include:

• Leading, mentoring, and managing a team of SIU investigators and support specialists, ensuring high performance, professional development, and adherence to best practices.
• Executing a strategic vision for fraud detection and prevention across all lines of business.
• Establishing and monitoring key performance indicators (KPIs) to measure the effectiveness of the SIU program.
• Collaborating with senior leadership to align SIU goals with broader organizational objectives.
• Overseeing the intake, triage, and assignment of suspected fraudulent claims, ensuring timely and thorough investigations.
• Directing the investigation of complex, high-value, or sensitive cases involving potential fraud, collusion, staged losses, or organized crime.
• Ensuring investigative activities are conducted in accordance with legal standards, company policies, and industry best practices.
• Reviewing and approving investigative reports, summaries, and referrals to law enforcement or regulatory bodies.
• Managing and implementing a comprehensive quality assurance program to evaluate the accuracy, completeness, and compliance of SIU investigations.
• Conducting regular audits of investigative files to ensure adherence to internal protocols, regulatory requirements, and industry standards.
• Providing feedback and coaching to investigators based on audit findings to drive continuous improvement.
• Monitoring trends in investigative performance and developing targeted training or process enhancements as needed.
• Ensuring timely and accurate reporting to state fraud bureaus, the NICB, and other regulatory entities.
• Ensuring compliance with all applicable state and federal regulations, including mandatory fraud reporting requirements.
• Maintaining accurate and timely documentation of all investigative activities in the case management system.
• Preparing and submitting regulatory reports, internal dashboards, and executive summaries as required to SIU Leadership.
• Serving as a primary liaison with state fraud bureaus, the National Insurance Crime Bureau (NICB), and other external agencies.
• Partnering with claims, underwriting, legal, and risk management teams to identify fraud trends and vulnerabilities.
• Providing training and guidance to claims staff on fraud indicators, red flags, and referral procedures.
• Representing the company at industry conferences, fraud task forces, and professional associations.
• Leveraging data analytics, predictive modeling, and fraud detection software to enhance investigative capabilities.
• Evaluating and implementing new tools and technologies to improve SIU efficiency and effectiveness.
• Occasional travel is required (up to 20%).
• Ability to sit at a desk and work on a computer for extended periods of time.
• May occasionally lift and/or move up to 10 pounds.
• Vision abilities required by this job include close vision and ability to adjust focus.

Competencies:

Team Leadership, Strategic Thinking, Decision-Making, Analytical Thinking, Interview & Surveillance, Evidence Evaluation, Compliance Awareness, Legal Collaboration, Documentation & Reporting, Audit & Review, Process Optimization, Training & Development, Case Management Systems, Data Analytics, Written Communication, Verbal Communication, Collaboration, Confidentiality, Ethical Standards.

Qualifications:

Minimum of 7–10 years of experience in insurance fraud investigations, with minimum of 3 years in a supervisory or managerial role. Extensive knowledge of commercial and personal insurance products and claims processes. Completion of one or more of the following designations: Fraud Claims Law Specialist (FCLS), Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner (CFE), Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC). Bachelor's degree in Criminal Justice, Insurance, Business Administration, or a related field.

Additional Requirements

Location and Travel: Primary location Urbandale, IA. Additional locations: High Point, NC; Irving, TX; Florida; Atlanta, GA; Glen Allen, VA; Chesterfield, MO; Scottsdale, AZ; Pennsylvania. Travel: Occasional travel is required (up to 20%).

Sponsorship Details

Sponsorship not Offered for this Role