Investigator, Special Investigations Unit

Job not on LinkedIn

🕒 6 days ago

🌪️ Oklahoma – Remote

info

💵 $43.9k - $76.5k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• thoroughly investigating any allegations of Medicaid healthcare fraud, waste, or abuse. • collaborating with Compliance, State Medicaid Plans, Health Plans, and Coding teams. • developing an investigation plan and gathering pertinent information. • managing an active caseload ensuring timely task completions and compliance. • interviewing healthcare providers, patients/members, and others.

🎯 Requirements

• Must reside in Oklahoma. • Experience in working healthcare investigations. • 2 years of experience in healthcare fraud investigation. • Experience with using fraud, waste, and abuse (FWA) detection tools and enterprise databases to support data mining, analysis, and information gathering. • Ability to travel and participate in legal proceedings, arbitrations, depositions, etc.

🏖️ Benefits

• medical coverage • dental coverage • vision coverage • paid time off • retirement savings options • wellness programs

Apply Now

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