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Manager, Special Investgations Unit

Work from home Full-time role Hiring

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 include leading and managing a team of SIU investigators, overseeing day-to-day fraud, waste, and abuse (FWA) investigations, and ensuring team performance against KPIs, productivity, and quality standards. This individual will review and escalate complex fraud cases, partner closely with compliance, legal, and external regulatory or law enforcement agencies, and support high-level investigations as needed. The Manager will also help prioritize investigations and guide the team through higher-risk cases while driving operational improvements by leveraging data and analytics to identify fraud trends and enhance detection strategies. Additionally, they will be responsible for developing reporting, tracking performance metrics, implementing process improvements and workflows, and collaborating cross-functionally with internal stakeholders to resolve complex issues and support broader SIU strategy. 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] 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/. Required Skills & Experience Bachelor's 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 Proficiency in Excel, PowerPoint, Word, SharePoint (Visio basic) Data-driven mindset with experience tracking performance and trends

Nice to Have

Skills & Experience Cert: Accredited Healthcare Fraud Investigator (AHFI) Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.

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