CVS Health is a leading healthcare company dedicated to helping people on their path to better health. With a diverse portfolio of services ranging from pharmacy benefits management to retail pharmacy, CVS Health is committed to improving the health and well-being of communities across the nation.

Job Title: Senior Investigator, Special Investigation Unit (Fully Remote)

Job Summary: As a Senior Investigator within the Special Investigation Unit (SIU) at CVS Health, you will play a critical role in protecting the integrity of our organization by conducting thorough investigations into potential fraud, waste, and abuse. This fully remote position offers an exciting opportunity to apply your investigative skills in a dynamic and fast-paced environment.

Key Responsibilities:

• Conduct comprehensive investigations into allegations of fraud, waste, and abuse within CVS Health programs and services.
• Utilize various investigative techniques, including data analysis and interviews, to gather evidence and identify potential misconduct.
• Collaborate with internal and external stakeholders, including law enforcement agencies and regulatory bodies, to facilitate investigations and ensure compliance with relevant laws and regulations.
• Prepare detailed investigative reports documenting findings, conclusions, and recommendations for corrective action.
• Provide expert testimony and support legal proceedings as needed.

Required Skills and Qualifications:

• Bachelor degree in Criminal Justice, Finance, or related field; advanced degree preferred.
• Minimum of 5 years of experience in conducting complex investigations, preferably in healthcare, insurance, or law enforcement.
• Strong analytical and problem-solving skills, with the ability to interpret complex data and identify patterns of fraudulent activity.
• Excellent communication skills, both written and verbal, with the ability to present findings clearly and persuasively.
• Proficiency in conducting interviews and interrogations, with a focus on eliciting accurate and actionable information.
• Familiarity with relevant laws, regulations, and investigative techniques, including knowledge of HIPAA and other healthcare compliance standards.

Experience:

• Minimum of 5 years of experience in conducting complex investigations, preferably in healthcare, insurance, or law enforcement.

Working Hours:

• This is a full-time position with standard business hours, Monday through Friday.

Knowledge, Skills, and Abilities:

• Strong analytical and problem-solving skills
• Excellent communication skills
• Proficiency in conducting interviews and interrogations
• Familiarity with relevant laws, regulations, and investigative techniques

Benefits:

• Competitive salary
• Comprehensive benefits package, including medical, dental, and vision coverage
• Retirement savings plan with company match
• Paid time off and holidays
• Professional development opportunities

Why Join CVS Health:At CVS Health, we are committed to making a difference in the lives of our customers and communities. As a Senior Investigator within our Special Investigation Unit, you will have the opportunity to contribute to our mission of improving health outcomes and reducing healthcare costs through the detection and prevention of fraud, waste, and abuse.

Interview Tips:

• Be prepared to discuss your experience conducting investigations and your knowledge of relevant laws and regulations.
• Highlight your analytical skills and ability to work independently in a remote environment.
• Emphasize your communication skills and experience presenting findings to stakeholders.

How to Apply: To apply for the Senior Investigator position at CVS Health, please visit our careers page and Submit your resume and cover letter outlining your qualifications and interest in the role. We look forward to reviewing your application!