Program Manager, Investigation Services

The Program Manager, Investigation Services is an exciting opportunity for an experienced insurance investigator who is ready to take the next step into people leadership. Leading a team of Investigation Analysts focused on dental and drug investigations, you will combine strong investigative judgment with coaching, development, and day-to-day leadership of the team. We are looking for someone who brings a strong foundation in insurance investigations and can help strengthen investigative thinking, practices, and capabilities across the team.

Previous formal people-leadership experience is not required; equally important is a demonstrated aptitude for coaching others, influencing outcomes, building strong relationships, and developing people. Experience with dental or drug investigations is an asset, but the technical benefits knowledge can be developed in the role.

• Lead, coach, and develop a team of Investigation Analysts, fostering strong investigative judgment, curiosity, collaboration, and accountability.
• Provide investigative guidance on complex, sensitive, or higher-risk files, including investigation strategy, evidence assessment, documentation, findings, and recommended outcomes.
• Promote consistent, high-quality investigative practices and support the continued development of the team’s investigative capabilities.
• Support Investigation Analysts in navigating challenging files, applying sound judgment, and reaching well-supported conclusions.
• Identify emerging fraud risks, trends, and investigative opportunities and work collaboratively with internal partners to determine appropriate responses.
• Build strong relationships with business partners and stakeholders to support effective investigations and sound decision-making.
• Support continuous improvement of investigative processes, tools, controls, and practices.
• Contribute to a positive, inclusive, and high-performing team environment where employees are supported in their development and encouraged to grow their capabilities.

• Experience with dental, drug, health benefits, or provider investigations.
• Knowledge of health and dental claims, provider practices, or related fraud risks.
• Previous experience in an informal or formal leadership capacity, including mentoring, coaching, leading complex investigations, or acting as a subject-matter expert.
• Experience using data and analytics to support fraud detection or investigations.
• Fraud or investigation-related education, training, or professional designation.
• Demonstrated experience conducting insurance investigations, with a strong understanding of investigative methodology and case development.

• Experience managing complex investigations, including gathering and assessing evidence, conducting interviews, documenting findings, and developing well-supported conclusions and recommendations.
• Strong investigative judgment, critical thinking, problem-solving, and analytical skills.
• Demonstrated aptitude for people leadership, including the ability to coach, influence, provide constructive feedback, build trust, and support the development of others.
• Strong written and verbal communication skills, including the ability to clearly articulate investigative findings, rationale, and recommendations.
• Ability to collaborate effectively with a variety of stakeholders and navigate sensitive or complex matters with sound judgment and discretion.
• Strong organizational skills with the ability to manage competing priorities while supporting the day-to-day needs of a team.

We’ll empower you to learn and grow the career you want. We’ll recognize and support you in a flexible environment where well-being and inclusion are…