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Manager, Special Investigations

3 months ago


Madison, United States American Family Insurance Full time

The SIU Manager is responsible for leading a multi-functional team including Triage Reps, and Analyst conducting major case research. This team utilizes data analytics and research investigation techniques to assess suspected questionable claims submitted by a variety of sources such as our Claims partners, predictive modeling tools, NICB, law enforcement, and agents.

The SIU Manager actively participates in departmental strategy and tactical planning and decision making while collaborating with internal and external business partners to ensure optimization of our fraud detection systems. You will have the skills to lead people inclusively, lead as an intrapreneur and lead innovation. You will report to Claims Director, Adjusting Services.

Position Compensation Range:
$95,000.00 - $161,000.00

Pay Rate Type:
Salary
- Compensation may vary based on the job level and your geographic work location._

Primary Accountabilities
- Create a collaborative, performance-driven work environment by facilitating and fostering trust, transparency, and inclusion. Work with team members to set clear goals, provide feedback, perform performance assessments, and support on-going development.
- Lead with influence and expertise. Actively contributes to division or department leadership team. Communicates and supports organization mission, vision, values, policies, and practices.
- Assess investigator resource capabilities and capacity to determine resource needs.
- Identify external expert and investigative resources, as needed, to supplement company resources and support the requirements of investigations.
- Monitor and reviews vendor investigation resources' work product for quality and timeliness.
- Implement and improve investigation guidelines. Works with investigators to ensure delivery of high-quality investigations.
- Assist investigators in determining course and extent of investigative activity required for resolution of the case.
- Collaborate with business partners to develop and implement effective anti-fraud plans and strategies to identify, prevent and mitigated fraudulent claim losses.
- Collaborate with fraud forensic analysts, examiners, and business partners to proactively identify insurance fraud activity.
- Develop and maintain meaningful relationships with members of the insurance industry, law enforcement agencies, and anti-fraud organizations to gather and share information regarding fraud.

Specialized Knowledge & Skills Requirements
- Demonstrated experience providing customer-driven solutions, support or service
- Demonstrated effective people management or project leadership experience.
- Solid knowledge of property and casualty claims operations including claims processes, procedures, best practices, and service levels.
- Solid knowledge of special investigation operations to include processes, performance measures, strategies, insurance fraud schemes and associated indicators.
- Demonstrated experience investigating suspected insurance fraud activity involving multi-line auto and property claims.
- Demonstrated experience developing and delivering anti-fraud detection training to internal and external business partners.
- Basic experience actively participating in special investigation industry associations and collaborating with special investigation industry peers to combat insurance fraud activity.
- Solid knowledge of appropriate federal, state and local laws, regulations and practices pertaining to states within designated operating territory.
- Prior experience with major case analytics
- Prior SIU experience (3-5 years)

In this flex office/home role, you will be expected to work a minimum of 10 days per month from one of the following office locations: Madison, WI 53783.

Other locations may be considered: Denver, CO 80112; Eden Prairie, MN 55343; Keene, NH 03431; St. Joseph, MO 64507; Phoenix, AZ 85034; Nashville, TN 37214, Atlanta, GA

LI-Hybrid

We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.

We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

LI-CF1