Are you a highly experienced investigator with a passion for uncovering fraud and protecting the integrity of the healthcare industry? CVS Health is seeking a Senior Investigator for our Special Investigations Unit (SIU) to join our dynamic team. As a Senior Investigator, you will play a critical role in preventing and detecting healthcare fraud, waste, and abuse. If you possess strong investigative skills, excellent communication and analytical abilities, and a commitment to upholding ethical standards, we want to hear from you. Join us in our mission to make healthcare more accessible, affordable, and effective for all.
Conduct thorough investigations into potential cases of healthcare fraud, waste, and abuse.
Utilize various investigative techniques and tools to gather evidence and identify potential fraudulent activity.
Work closely with law enforcement and legal teams to build cases and support criminal or civil actions.
Conduct interviews and gather statements from witnesses and subjects of investigations.
Analyze data and financial records to identify trends and patterns of fraudulent activity.
Develop and maintain relationships with internal and external stakeholders to gather information and collaborate on investigations.
Stay up-to-date on industry regulations and best practices related to fraud detection and prevention.
Prepare detailed reports and presentations on investigation findings and recommendations for corrective action.
Participate in training and education initiatives to enhance knowledge and skills related to fraud detection and investigation.
Serve as a subject matter expert on fraud-related matters and provide guidance and support to other team members.
Conduct risk assessments and develop strategies to mitigate potential fraud risks.
Maintain strict confidentiality and adhere to ethical standards in all aspects of investigations.
Testify in court or other legal proceedings as needed.
Monitor and track outcomes of investigations to ensure appropriate actions are taken and potential risks are mitigated.
Collaborate with cross-functional teams to implement fraud prevention and detection strategies and initiatives.
CVS Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
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