Job Description
Manager, Special Investigations Unit (Healthcare Fraud Investigations) Location: Houston, TX (Hybrid - 3 days onsite, 2 days remote) Schedule: M-F, 8:00 AM - 5:00 PM Pay Range: $92,8000 - $116,000 / Annually
Employment Type: Full-Time | Exempt
Industry: Nonprofit Healthcare Coverage Organization
We are on a mission to create care that's more convenient and professional-with solutions that are value-based and patient-centered. To accomplish this, we are looking for individuals who share our sense of excellence and are ready to embrace new opportunities.
Dean's Professional Services is currently seeking a Manager, Special Investigations Unit (SIU) for a full-time, hybrid opportunity with a nonprofit healthcare coverage organization serving communities across Texas. This is a leadership role focused on rebuilding the SIU department , with direct responsibility over one current team member and four planned hires. The Manager will report directly to the Chief Compliance Officer.
Position Summary
The Manager, Special Investigations Unit (SIU) is responsible for leading a team that investigates and mitigates healthcare fraud, waste, and abuse (FWA) across Medicaid, CHIP, and Commercial lines of business. This role manages case strategy, provider claim reviews, overpayment recovery, regulatory and law enforcement referrals, and staff development. The position plays a key role in rebuilding the SIU department and setting the tone for integrity, efficiency, and strategic compliance.
Key Responsibilities
Lead day-to-day operations of the SIU team, including performance oversight and resource planning
Analyze provider billing patterns, medical records, and claim data to identify potential FWA
Manage vendor relationships and oversee delegated investigative work
Collaborate with internal Legal and Compliance teams and serve as a resource in civil/criminal matters
Build out and train a high-performing team of investigators (total team of 5 once filled)
Design and implement process improvements that ensure compliance with federal/state standards
Promote fraud awareness and provide cross-departmental training
Qualifications
Required:
Bachelor's degree
5+ years of experience in healthcare fraud investigations
3+ years of experience in a leadership/management role within SIU
AHFI, CFE, or similar certification (or ability to obtain within 12 months)
Proficiency in Microsoft Office Suite
Preferred:
Graduate degree
Knowledge of Medicaid/Medicare regulations and healthcare claims processing
Familiarity with CPT and ICD-10 coding and medical terminology
Experience collaborating with regulatory and law enforcement agencies
Ideal Candidate
Proven leader with experience rebuilding or growing departments
Detail-oriented and process-driven
Strong communication and analytical skills
Committed to ethical standards and mission-driven outcomes
Comfortable working in a hybrid environment with flexibility and accountability
Dean's Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 50,000 professionals across the nation. We work with our clients to provide placement opportunities that match your skill, experience, and personality. For more information, please visit .
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Job Tags
Full time, Work at office,