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.

What you will work on

Key Responsibilities

• Provide operational

  leadership and oversight for SIU programs, processes, and day-to-day

  activities.

• Drive consistency,

  efficiency, and quality across investigative, audit, and

  compliance-related workflows.

• Assess current operational

  processes and identify opportunities for standardization, optimization,

  and continuous improvement.

• Develop and implement process

  enhancements that improve productivity, turnaround times, and overall team

  effectiveness.

• Serve as a resource for

  complex operational questions, escalations, and process-related

  challenges.

• Monitor performance metrics,

  operational trends, and key deliverables to support informed

  decision-making.

• Ensure adherence to

  regulatory requirements, internal policies, documentation standards, and

  compliance expectations.

• Partner with internal

  stakeholders across Compliance, Audit, Legal, Medical Management, and

  Operations to support program objectives.

• Create and maintain

  operational workflows, standard operating procedures (SOPs), and best

  practices.

• Provide regular updates,

  recommendations, and strategic insights to senior leadership regarding

  operational performance and improvement opportunities.

• Support change management

  initiatives and promote adoption of enhanced business processes.

What you will bring

Qualifications

• Bachelor's degree required;

  advanced degree or certifications such as CFE, AHFI, CHC, or equivalent

  preferred.

• 7+ years of progressive

  leadership experience in healthcare compliance, SIU, fraud, waste and

  abuse (FWA), investigations, audit, or health plan operations.

• Demonstrated success leading

  operational improvement initiatives and implementing sustainable business

  processes.

• Strong understanding of

  managed care operations, healthcare regulations, CMS requirements, and FWA

  programs.

• Proven ability to evaluate

  workflows, identify gaps, and implement process improvements that drive

  measurable results.

• Excellent analytical,

  organizational, and problem-solving skills.

• Strong leadership,

  communication, and stakeholder management capabilities.

• Ability to quickly assess

  operational needs and provide effective leadership in a temporary or

  interim capacity.

What you can expect

• 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).

What we do 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.

Our values guide everything we do and strengthen our commitment to people. By combining smart processes, human-centered design, and advanced technology, we celebrate our team's excellence and ensure we grow together. We believe in the power of continuous learning and development to drive both individual and organizational success. It’s time to rethink how work gets done. Dare to Work Differently® with RGP.

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.