Ohio BWC (official)
BWC Special Investigations Manager - PN: 20066661
Ohio BWC (official), Frankfort, Kentucky, United States
BWC Special Investigations Manager - PN: 20066661
Join to apply for the BWC Special Investigations Manager - PN: 20066661 role at Ohio BWC (official).
BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, although daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.
This position’s HQ county will be out of the closest service office to the selected candidate.
What Our Employees Have To Say
BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
I have worked at several state agencies and BWC is the best place to work.
Best place to work in the state and with a sense of family and support.
I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.
What You’ll Be Doing
Directs and manages multiple regional Special Investigations Units (SIUs) and the Statewide Healthcare Provider Team.
Develops and recommends policies and legislative changes to enhance fraud prevention and investigation efforts.
Overseas the administration of fraud detection and investigation programs targeting internal and external actors (e.g., employees, providers, employers, injured workers).
Ensures adherence to federal, state, and local laws in all investigative activities.
Directs the development and delivery of training programs for investigative staff.
Promotes the use of modern investigative techniques and technologies.
Reviews complex and high-profile fraud cases for accuracy, completeness, and procedural compliance.
Provides guidance on investigative techniques and ensures consistency in case handling.
5 yrs. investigative training or experience with experience corresponding to insurance fraud; 3 yrs. training or 3 yrs. experience in supervisory or managerial position associated with criminal investigation or insurance claims or insurance fraud department; valid Ohio driver’s license.
Or 6 yrs. investigative training or experience where experience does not correspond to insurance fraud; 3 yrs. training or 3 yrs. experience in supervisory principles/ techniques; valid Ohio driver’s license.
Or equivalent of Minimum Class Qualifications For Employment noted above.
Job Skills Investigation
Major Worker Characteristics Knowledge of: WC laws, policies & procedures; eligibility criteria & procedures used for processing WC claims; English grammar; oral & written business communication; investigative practices & techniques; case preparation; rules of evidence; public relations; employee training & development; management principles/techniques; Fraud Division investigation policies, procedures & techniques; labor relations.
Skill in: use of PC; operation of motor vehicle; interviewing.
Ability to: define problems, collect data, establish facts & draw complex conclusions; read & understand medical reference manuals; write meaningful, accurate & concise reports, gather, collate & classify information about data, people or things; respond to sensitive inquiries from & contacts with injured workers, employers, providers, public officials, law enforcement & other agencies; establish friendly atmosphere as supervisor of department.
Position is overtime exempt and unclassified pursuant to ORC 124.11(A)(9).
Valid driver’s license required; position requires travel and persons must provide their own transportation or legally operate a state owned vehicle.
May be exposed to physical harm; final external applicant selected must submit to urinalysis prior to appointment; applicant with a positive test result will NOT be offered employment. Final applicant must submit to & pass an extensive background check by the Ohio State Patrol prior to appointment.
Position may involve overnight travel; position may involve flexible schedule including nights, early morning, weekends &/or holiday hours.
Organization Workers' Compensation
Agency Contact Name and Information Matthew Palte - HCM Sr. Analyst: Matthew.P.2@bwc.ohio.gov
Seniority level Director
Employment type Full-time
Job function Research and Other
Industries Government Administration
Agency Overview With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.
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BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, although daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.
This position’s HQ county will be out of the closest service office to the selected candidate.
What Our Employees Have To Say
BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
I have worked at several state agencies and BWC is the best place to work.
Best place to work in the state and with a sense of family and support.
I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.
What You’ll Be Doing
Directs and manages multiple regional Special Investigations Units (SIUs) and the Statewide Healthcare Provider Team.
Develops and recommends policies and legislative changes to enhance fraud prevention and investigation efforts.
Overseas the administration of fraud detection and investigation programs targeting internal and external actors (e.g., employees, providers, employers, injured workers).
Ensures adherence to federal, state, and local laws in all investigative activities.
Directs the development and delivery of training programs for investigative staff.
Promotes the use of modern investigative techniques and technologies.
Reviews complex and high-profile fraud cases for accuracy, completeness, and procedural compliance.
Provides guidance on investigative techniques and ensures consistency in case handling.
5 yrs. investigative training or experience with experience corresponding to insurance fraud; 3 yrs. training or 3 yrs. experience in supervisory or managerial position associated with criminal investigation or insurance claims or insurance fraud department; valid Ohio driver’s license.
Or 6 yrs. investigative training or experience where experience does not correspond to insurance fraud; 3 yrs. training or 3 yrs. experience in supervisory principles/ techniques; valid Ohio driver’s license.
Or equivalent of Minimum Class Qualifications For Employment noted above.
Job Skills Investigation
Major Worker Characteristics Knowledge of: WC laws, policies & procedures; eligibility criteria & procedures used for processing WC claims; English grammar; oral & written business communication; investigative practices & techniques; case preparation; rules of evidence; public relations; employee training & development; management principles/techniques; Fraud Division investigation policies, procedures & techniques; labor relations.
Skill in: use of PC; operation of motor vehicle; interviewing.
Ability to: define problems, collect data, establish facts & draw complex conclusions; read & understand medical reference manuals; write meaningful, accurate & concise reports, gather, collate & classify information about data, people or things; respond to sensitive inquiries from & contacts with injured workers, employers, providers, public officials, law enforcement & other agencies; establish friendly atmosphere as supervisor of department.
Position is overtime exempt and unclassified pursuant to ORC 124.11(A)(9).
Valid driver’s license required; position requires travel and persons must provide their own transportation or legally operate a state owned vehicle.
May be exposed to physical harm; final external applicant selected must submit to urinalysis prior to appointment; applicant with a positive test result will NOT be offered employment. Final applicant must submit to & pass an extensive background check by the Ohio State Patrol prior to appointment.
Position may involve overnight travel; position may involve flexible schedule including nights, early morning, weekends &/or holiday hours.
Organization Workers' Compensation
Agency Contact Name and Information Matthew Palte - HCM Sr. Analyst: Matthew.P.2@bwc.ohio.gov
Seniority level Director
Employment type Full-time
Job function Research and Other
Industries Government Administration
Agency Overview With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.
#J-18808-Ljbffr