Manager, Special Investgations Unit

Job Description

Insight Global is looking for a Manager, Special Investigations Unit (SIU) (Healthcare Fraud, Waste & Abuse) for a 4-month contract supporting a large, publicly operated health plan. This role is fully remote, working PST hours.

This position is part of a high-volume fraud initiative, where the team is focused on driving through a large volume of complex cases and improving overall investigation throughput.

Responsibilities

• Lead and manage a team of SIU investigators.
• Oversee day-to-day fraud, waste, and abuse (FWA) investigations.
• Ensure team performance against KPIs, productivity, and quality standards.
• Review and escalate complex fraud cases.
• Partner closely with compliance, legal, and external regulatory or law enforcement agencies.
• Support high-level investigations as needed.
• Prioritize investigations and guide the team through higher-risk cases.
• Drive operational improvements by leveraging data and analytics to identify fraud trends and enhance detection strategies.
• Develop reporting, track performance metrics, and implement process improvements and workflows.
• Collaborate cross-functionally with internal stakeholders to resolve complex issues and support broader SIU strategy.

Skills and Requirements

• Bachelor's degree required; Master's (Criminal Justice, Law, or related) preferred.
• 5 years of experience in fraud investigations (healthcare or related industry).
• 3 years of leadership or people management experience.
• Proven experience managing investigation teams, including performance, productivity, and case quality.
• Strong communication and stakeholder management skills.
• Proficiency in Excel, PowerPoint, Word, and SharePoint (Visio basic).
• Data-driven mindset with experience tracking performance and trends.
• Certification: Accredited Healthcare Fraud Investigator (AHFI).

Equal Opportunity Employer

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [email protected]. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.