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.
Extensive Experience In Investigative Work: The Ideal Candidate For A Senior Investigator Role At Cvs Health Should Have A Minimum Of 5 Years Of Experience In Conducting Investigations, Preferably In A Corporate Or Healthcare Setting. They Should Also Have A Strong Understanding Of Investigative Techniques, Procedures, And Best Practices.
Knowledge Of Fraud And Abuse Laws: A Senior Investigator Must Be Well-Versed In Federal And State Laws Related To Healthcare Fraud, Waste, And Abuse. They Should Have A Solid Understanding Of Statutes Such As The False Claims Act, Anti-Kickback Statute, And Stark Law.
Analytical And Critical Thinking Skills: This Role Requires Strong Analytical And Critical Thinking Abilities To Identify Patterns, Trends, And Discrepancies In Data And Information. A Senior Investigator Should Be Able To Effectively Analyze Complex Information And Draw Conclusions That Support Investigative Findings.
Excellent Communication And Interpersonal Skills: As A Senior Investigator, The Candidate Will Be Required To Interact With Various Stakeholders, Including Law Enforcement Agencies, Attorneys, And Internal Teams. Therefore, Strong Communication And Interpersonal Skills Are Essential For This Role.
Attention To Detail And Time Management: Investigative Work Requires Meticulous Attention To Detail And The Ability To Manage Multiple Tasks And Deadlines. A Senior Investigator Must Be Able To Prioritize And Manage Their Workload Effectively To Ensure Timely And Accurate Completion Of Investigations.
Communication Skills
Data Analysis
Time Management
Interviewing skills
Case management
Risk assessment
Investigative Research
Fraud detection
Compliance monitoring
Evidence Collection
Surveillance Techniques
Communication
Conflict Resolution
Leadership
Problem Solving
Time management
creativity
Critical thinking
Attention to detail
Teamwork
Adaptability
According to JobzMall, the average salary range for a SIU Senior Investigator is between $72,000-$95,000 per year. This may vary depending on factors such as location, experience, and the specific company or organization hiring for the position.
Apply with Video Cover Letter Add a warm greeting to your application and stand out!
CVS Health Corp. engages in the provision of health care services. It operates trough the following segments: Pharmacy Services, Retail or Long Term Care, and Corporate. The Pharmacy Services segment offers pharmacy benefit management solutions. The Retail or Long Term Care segment includes selling of prescription drugs and assortment of general merchandise. The Corporate segment involves in providing management and administrative services.
Get interviewed today!
JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.
Get Started