Manager, Special Investigations (P1-1696375-1)

Summary of Job Description:

The Manager, Special Investigations manages a group of Investigators and performs investigations over a broad geographical area.This position manages a team that supports the PRG Risk Management program by investigating and mitigating workers' compensation fraud, abusive claims, and other related misconduct. The Manager conducts complex investigations, analyzes data for fraud indicators, and provides actionable recommendations to reduce exposure and enhance claims integrity.

You'll get a chance to:

• Manages a team of Investigators that supports the PRG Risk Management program by investigating and mitigating workers' compensation fraud, abusive claims, and other related misconduct.Develops and coaches team members to elevate their performance.Assists Risk Management leadership with recruiting and retaining team members.
• Plans and executes complex investigations over a broad geographic area involving suspected workers' compensation and insurance fraud and evaluates potentially fraudulent activities, including falsified documents.Presents findings in comprehensive reports to support claim denial or mitigation strategies.
• Manages external investigators and collaborates with legal teams to develop case strategies.
• Utilizes data mining and social media analysis tools to identify inconsistencies and recommend targeted surveillance.Conducts AOE/COE (Arising Out of Employment/Course of Employment) investigations and analysis to determine claim validity.
• Prepares and refers cases of suspected fraud to legal authorities, including local District Attorneys and state fraud divisions.Testifies in legal or administrative proceedings, including Workers' Compensation Appeals Boards.
• Conducts fraud awareness training for staff and management as needed.
• Assists with guest issues on occasion, providing support for risk management-related incidents.
• Develops and implements policies to reduce claims fraud and abuse.Ensures investigations are in compliance with all applicable safety and associate relations/EEO policies.

How we reward you:

• Hybrid remote schedule
• 401K with company match
• Yearly bonus opportunity*
• Full medical, dental, and vision insurance *
• On-site fitness center, biometric screen, and flu shot clinic
• Discounts at Panda restaurants, theme parks, and gym memberships
• Paid time off starting at 15 days with 7 federal holidays*
• Continuous education assistance and scholarships*
• Income protection including Disability, Life and AD&D insurance*
• Bereavement leave*

*Benefits available for eligible permanent full time associates

Your background & experience:

• College degree or comparable experience required
• Minimum five years of experience in workers' compensation investigations, insurance fraud, risk management, or a related field, with increasing management responsibility
• Valid California Class C Driver's License required.
• Certified Professional in Fraud Identification (CPFI) or Private Investigator license required
• Successful completion of initial and periodically required training
• Obtaining a valid Food Handler's Card within 30 days of employment is a requirement of this position.

Pay Range: M2: $112,500 - $158,000 / Annual

* Within the range, individual pay is determined using various factors, including work location and experience.

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