Aetna

Analyst, Special Investigative Unit

Aetna

Remote
Full-TimeDepends on ExperienceMid-LevelBachelors
Job Description

Are you a highly motivated and detail-oriented individual with a passion for uncovering fraudulent activities? Do you thrive in a fast-paced environment, where you can use your analytical skills to make a difference? Aetna is seeking a dedicated and experienced Analyst to join our Special Investigative Unit (SIU). As an Analyst, you will play a crucial role in detecting and preventing fraudulent behavior within our organization. This is a unique opportunity to join a dynamic team and contribute to the overall success of Aetna. If you have a strong investigative mindset and meet the qualifications listed below, we encourage you to apply and be a part of our mission to provide quality healthcare to our members.

  1. Conduct thorough and detailed investigations into potential fraudulent activities within the organization.
  2. Utilize analytical skills and tools to identify patterns and trends in data that may indicate fraudulent behavior.
  3. Collaborate with other team members to gather and analyze information from multiple sources.
  4. Prepare and present reports and findings to management and relevant stakeholders.
  5. Develop and maintain strong relationships with internal departments and external partners to share information and coordinate efforts.
  6. Stay up-to-date on industry trends and best practices for fraud detection and prevention.
  7. Follow established protocols and procedures for handling and documenting investigations.
  8. Identify potential areas of vulnerability and make recommendations for process improvements to mitigate fraud risk.
  9. Maintain confidentiality and handle sensitive information with discretion.
  10. Communicate findings and recommendations to management and assist in implementing necessary changes.
  11. Participate in training and development opportunities to enhance investigative skills and knowledge.
  12. Adhere to all legal and regulatory requirements related to fraud detection and prevention.
  13. Collaborate with law enforcement and other external entities as needed.
  14. Represent the organization in a professional and ethical manner at all times.
  15. Work independently and efficiently to meet deadlines and achieve goals set by management.
Where is this job?
This job opening is listed as 100% remote
Job Qualifications
  • Bachelor's Degree In A Relevant Field Such As Criminal Justice, Accounting, Or Healthcare Administration.

  • Minimum Of 3 Years Experience In Fraud Investigations, Preferably In The Healthcare Industry.

  • Strong Analytical Skills And Ability To Interpret Data And Identify Patterns Of Potential Fraud.

  • Knowledge Of Federal And State Laws Related To Healthcare Fraud And Abuse.

  • Excellent Communication And Interpersonal Skills, With The Ability To Collaborate With Cross-Functional Teams And Present Findings To Management.

Required Skills
  • Data Analysis

  • Interviewing skills

  • Report Writing

  • CASE

  • Research skills

  • Risk assessment

  • Team collaboration

  • Fraud prevention

  • Documentation management

  • Fraud detection

  • Compliance monitoring

  • Investigation Techniques

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • Time management

  • creativity

  • Attention to detail

  • Teamwork

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Analyst, Special Investigative Unit is $50,000 to $85,000 per year. However, this can vary depending on factors such as experience, location, and the specific industry or company the analyst works for. Some high-paying industries for this position may include healthcare, insurance, and financial services. Additionally, analysts with advanced degrees or certifications may be able to command higher salaries.

Additional Information
Aetna 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.
Required LanguagesEnglish
Job PostedMarch 13th, 2025
Apply BeforeSeptember 18th, 2025
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About Aetna

Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.

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