Senior Investigator, Aetna SIU (Must reside in Ohio)
Clinical Careers Page(1 month ago)
About this role
A Senior Investigator at CVS Health focuses on preserving program integrity by examining suspected healthcare fraud and abuse within Medicaid lines of business. The role supports legal and clinical review processes and works with internal and external partners to protect members and recover improper payments.
Required Skills
- Medical Coding
- CPT
- HCPCS
- ICD10
- Excel
- Pivot Tables
- Data Mining
- Analytical Skills
- Research
- Communication
+4 more
Qualifications
- Bachelor's Degree
- CFE
- AHFI
About Clinical Careers Page
cvshealth.comCVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.
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