Analyst - Special Investigation Unit

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Position SummaryIn this role, you will be responsible for conducting investigations of known or suspected acts of healthcare/disability fraud and abuse, communicating with federal, state, and local law enforcement agencies as appropriate in matters pertaining to the prosecution of specific healthcare fraud cases, as well as investigating to prevent payment of fraudulent claims committed by insureds, providers, claimants, customer members, etc.You will facilitate the recovery of company and customer money lost as a result of fraud matters and provide input regarding controls for monitoring fraud-related issues within the business units. You will be delivering educational programs designed to promote deterrence and detection of fraud and minimize losses to the company while maintaining open communication with constituents within and external to the company.You will be able to use available resources and technology in developing evidence, supporting allegations of fraud and abuse to research and prepare cases for clinical and legal review and document for appropriate case activity in the tracking system.You will make referrals both internal and external, in the required timeframe, and cost-effectively manage the use of outside resources and vendors to perform activities necessary for investigations.Required Qualifications2+ years of experience with investigations.Preferred QualificationsHealthcare/insurance investigation experience.EducationBachelor's Degree or equivalent work experience.Pay RangeThe typical pay range for this role is: $43,888.00 - $93,574.80. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above.In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.For more detailed information on available benefits, please visit

Benefits | CVS Health .We anticipate the application window for this opening will close on: 11/24/2024.Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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