Senior SIU Operations Manager

We are seeking a highly experienced Senior Operations Manager to provide operational leadership and process oversight within the Special Investigations Unit (SIU). This interim role will focus on optimizing workflows, improving operational efficiency, strengthening cross-functional collaboration, and ensuring consistent execution of SIU processes. The ideal candidate will bring a combination of healthcare compliance, investigative operations, and business process expertise to support a high-performing and compliant SIU function.

Key Responsibilities

• Provide operationalleadership and oversight for SIU programs, processes, and day-to-dayactivities.

• Drive consistency,efficiency, and quality across investigative, audit, andcompliance-related workflows.

• Assess current operationalprocesses and identify opportunities for standardization, optimization,and continuous improvement.

• Develop and implement processenhancements that improve productivity, turnaround times, and overall teameffectiveness.

• Serve as a resource forcomplex operational questions, escalations, and process-relatedchallenges.

• Monitor performance metrics,operational trends, and key deliverables to support informeddecision-making.

• Ensure adherence toregulatory requirements, internal policies, documentation standards, andcompliance expectations.

• Partner with internalstakeholders across Compliance, Audit, Legal, Medical Management, andOperations to support program objectives.

• Create and maintainoperational workflows, standard operating procedures (SOPs), and bestpractices.

• Provide regular updates,recommendations, and strategic insights to senior leadership regardingoperational performance and improvement opportunities.

• Support change managementinitiatives and promote adoption of enhanced business processes.

Qualifications

• Bachelor's degree required;advanced degree or certifications such as CFE, AHFI, CHC, or equivalentpreferred.

• 7+ years of progressiveleadership experience in healthcare compliance, SIU, fraud, waste andabuse (FWA), investigations, audit, or health plan operations.

• Demonstrated success leadingoperational improvement initiatives and implementing sustainable businessprocesses.

• Strong understanding ofmanaged care operations, healthcare regulations, CMS requirements, and FWAprograms.

• Proven ability to evaluateworkflows, identify gaps, and implement process improvements that drivemeasurable results.

• Excellent analytical,organizational, and problem-solving skills.

• Strong leadership,communication, and stakeholder management capabilities.

• Ability to quickly assessoperational needs and provide effective leadership in a temporary orinterim capacity.

• An inspirational place for you to do your best work, be engaged in meaningful ways, and continually develop the skills, competencies and qualities that set our team apart.

• Compensation commensurate with your qualifications, experience, and other factors including geographic location, market and operational factors.

• Total Rewards include: Medical, Dental, Vision, Life Insurance, Disability Insurance, 401(k) Savings Plan, Employee Stock Purchase Plan, Professional Development Program, Paid Time Off and Paid Sick Time (in geographies where legally required).

At RGP, we're creating a future where businesses produce their best work without constraints. We've built a global network of over 2,600 experts across four regions, providing a comprehensive suite of solutions across on-demand talent, next-generation consulting, and outsourced services to support organizations at every stage of their growth journey. Trusted by Fortune 100 companies and emerging disruptors alike, we challenge conventional ways of working, drive growth, and pave the way for long-term success through bold innovation and fearless collaboration.

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RGP is proud to be an Equal Opportunity Employer and committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, national origin, gender, pregnancy, sexual orientation, gender identity, age, physical or mental disability, genetic information, veteran status, or any other legally protected trait and encourage all applicants to apply.