Description

The SIU Director serves as the primary strategic and operational lead for Allied Universal’s Special Investigations Unit (SIU) program. This role is responsible for oversight of SIU case inventory, client engagement, investigative quality, and program performance.

A critical component of this role includes acting as the primary triage analyst for the I-Score Rules Engine, overseeing daily claim scoring outputs, prioritizing high-risk claims, and directing investigative strategies based on predictive analytics.

The SIU Director partners closely with client stakeholders to enhance fraud detection, ensure regulatory compliance, and deliver measurable SIU outcomes and return on investment.

Location & Work Environment

• Remote position, with preference for candidates located in the Greater Atlanta, GA or Greater Charlotte, NC areas
• Monthly in-person office visits required at client locations (primarily Alpharetta, GA and Charlotte, NC)
• Additional travel may be required based on client needs

Key Responsibilities

SIU Program Leadership & Client Partnership 

• Serve as the primary SIU lead and point of contact 
• Provide strategic guidance on SIU program development, execution, and optimization
• Ensure all client SIU requirements and regulatory obligations are met
• Lead monthly client roundtables and ongoing collaboration with Claims leadership
• Deliver actionable insights to improve fraud detection and investigative outcomes

I-Score Triage & Analytics Oversight

• Act as the primary triage analyst for the I-Score Rules Engine
• Review daily/nightly scored claims and manage escalation into the SIU review queue (“bullpen”)
• Prioritize high-risk claims and determine appropriate investigative pathways
• Partner with SIU Analysts to refine scoring logic and improve hit rates
• Leverage data outputs, predictive indicators, and link analysis tools to guide investigations
• Ensure alignment between analytics outputs and real-world investigative execution

Investigative Oversight & Case Management

• Oversee SIU case inventory and ensure timely, high-quality completion of investigations
• Review and game plan complex or high-exposure investigations
• Provide technical direction and mentorship to SIU investigators
• Conduct in-house investigative activities when necessary
• Collaborate with Claims teams to identify and act on suspicious claims

Technology & Intelligence Utilization

• Utilize SIU technology suite including:
• Document and image validation tools
• Fraud databases and known bad actor lists
• Link analysis platforms (e.g., i2 intelligence)
• Support continued adoption and optimization of SIU technology solutions
• Reporting, Insights & Training
• Produce quarterly SIU performance reports, including:
• Program outcomes
• ROI analysis
• Identify trends and provide strategic recommendations to the client
• Deliver fraud awareness and line-of-business training to Claims teams
• Quality Assurance & Compliance
• Ensure compliance with all state SIU regulations and reporting requirements
• Partner with the SIU Compliance Team on regulatory deliverables
• Monitor investigative quality and identify opportunities for enhancement
• Ensure adherence to SLA metrics and operational standards

Requirements

Essential Functions:

• Manage SIU service delivery including referrals, reviews, and investigative assignments
• Provide expert consultation on complex fraud matters
• Maintain accountability for program performance and growth
• Support development of new SIU products and capabilities
• Travel for client engagement as needed

Requirements:

• Bachelor’s degree required (or equivalent experience)
• 5–7 years of experience in complex insurance investigations
• 2+ years of leadership or managerial experience in an SIU or investigative environment
• Strong understanding of insurance fraud trends, claims handling, and SIU regulations
• Experience with analytics-driven investigations or fraud detection tools preferred
• Proficiency in Microsoft Office (Excel, Word, PowerPoint, Outlook)
• Excellent communication, organizational, and analytical skills
• Valid driver’s license and willingness to travel as needed

Preferred Qualifications:

• Experience working with or supporting carrier SIU programs
• Familiarity with Guidewire or claims management systems
• Exposure to predictive analytics tools or rules engines (e.g., I-Score or similar platforms)
• Experience presenting to senior client stakeholders

What Success Looks Like:

• Increased identification and referral of high-quality SIU cases
• Measurable ROI and improved fraud detection outcomes
• Strong client satisfaction and partnership 
• Effective integration of analytics into investigative workflows
• Consistent delivery of high-quality investigative products